Violent crime and preterm birth: which places matter? Open Access

Gobaud, Ariana (Spring 2019)

Permanent URL: https://etd.library.emory.edu/concern/etds/4f16c380d?locale=en%255D
Published

Abstract

Background:Preterm birth, delivery at less than 37 weeks’ gestation, and early term birth, delivery between 37- and 38-weeks’ gestation, are major causes of morbidity and mortality in newborns. The risk of preterm or early term birth is not fully explained by individual maternal risk factors. Some evidence suggests living in a high crime neighborhood is a source of psychosocial stress, which may increase the risk of preterm birth. How neighborhood is measured, however, may yield different results.

Methods: A subset of African American women from the Microbiome and Preterm Birth Cohort Study (n = 485) were enrolled in the Spatial Exposure and Microbiome Study (n = 113). Information on maternal demographics, birth outcome, and places they frequent was provided through a questionnaire. Crime data was used from various police reports in Atlanta, GA from 2013. Logistic regression was used to investigate the association between violent crime rates measured at either the census block group or routine activity space on the probability of preterm or early term birth, controlling for potential confounders. 

Results: In this Atlanta-based study, 39.8% of participant women deliver preterm or early term. Controlling for age, education, and number of previous births, the odds of preterm or early term birth increased 1.09 (95% CI: 0.74, 1.62) for every one standard deviation change in residential crime, compared to those who had a term birth. Controlling for the same confounders, a one standard deviation change in activity space crime increased preterm or early term birth 12% (OR: 1.12, 95% CI: 0.72, 1.69). Controlling for all confounders, the odds of preterm or early term birth increased 27% (OR: 1.27, 85% CI: 0.85, 1.88) for every one standard deviation change in activity space crime adjusted for time spent in each location, compared to those who had a term birth. 

Discussion: There is evidence of an association between area based violent crime and risk of preterm or early term birth, when considering violent crime rate at either the residential or activity space level. Crime measured in activity spaces has a modestly stronger association with preterm or early term birth than crime measured using residential neighborhoods.

Table of Contents

Table of Contents

Background/Literature Review

Methods

Results

Discussion

References

Table 1. Distribution of U.S. Singleton Live African American Births in residential violent crime rate quartiles of metro Atlanta, GA

Table 2. Demographics and health characteristics of infants and mothers of infants born preterm (PTB) and early term in a cohort of U.S. Singleton Live African American Births

Table 3.Odds of preterm birth or early term birthin a cohort of U.S. Singleton Live African American Births when using different measurements of neighborhood violent crime ratesd for the exposure

Figure 1. Risk density of violent crimein block groups in metro Atlanta, GA

Figure 2. Scatterplot matrix of residential crimeversus activity space crime, activity space crime adjusted for time, and activity space crime adjusted for frequency

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