Neighbourhood deprivation and small-for-gestational-age term births in the United States

Paediatr Perinat Epidemiol. 2009 Jan;23(1):87-96. doi: 10.1111/j.1365-3016.2008.00991.x.


Residential context has received increased attention as a possible contributing factor to race/ethnic and socio-economic disparities in birth outcomes in the United States. Utilising vital statistics birth record data, this study examined the association between neighbourhood deprivation and the risk of a term small-for-gestational-age (SGA) birth among non-Hispanic whites and non-Hispanic blacks in eight geographical areas. An SGA birth was defined as a newborn weighing <10th percentile of the sex- and parity-specific birthweight distribution for a given gestational week. Multi-level random intercept logistic regression models were employed and statistical tests were performed to examine whether the association between neighbourhood deprivation and SGA varied by race/ethnicity and study site. The risk of term SGA was higher among non-Hispanic blacks (range 10.8-17.5%) than non-Hispanic whites (range 5.1-9.2%) in all areas and it was higher in cities than in suburban locations. In all areas, non-Hispanic blacks lived in more deprived neighbourhoods than non-Hispanic whites. However, the adjusted associations between neighbourhood deprivation and term SGA did not vary significantly by race/ethnicity or study site. The summary fully adjusted pooled odds ratios, indicating the effect of one standard deviation increase in the deprivation score, were 1.15 [95% CI 1.08, 1.22] for non-Hispanic whites and 1.09 [95% CI 1.05, 1.14] for non-Hispanic blacks. Thus, neighbourhood deprivation was weakly associated with term SGA among both non-Hispanic whites and non-Hispanic blacks.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Black People / statistics & numerical data*
  • Black or African American
  • Female
  • Gestational Age
  • Health Services Accessibility / economics
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age*
  • Poverty*
  • Pregnancy
  • Residence Characteristics*
  • Risk Factors
  • Social Environment
  • Socioeconomic Factors
  • Stress, Psychological / complications
  • United States / epidemiology
  • Urban Health / standards
  • White People / statistics & numerical data*