The Impact of Neighborhood Conditions and Psychological Distress on Preterm Birth in African-American Women.
Carmen Giurgescu, Shannon N Zenk, Thomas N Templin and 3 others
PMID 27891658WHAT IT FOUND
Pregnant African American women who saw their neighborhood as more disorderly or unsafe reported more distress and were more likely to have a preterm birth.
Address-based neighborhood data did not show this. The study had 101 women and only 9 preterm births.
Key findings
01Women who perceived more physical disorder, social disorder, or crime in their neighborhood reported more psychological distress.
02Objective neighborhood measures were not related to psychological distress.
03In the mediation model, perceived neighborhood conditions were related to distress, distress was related to preterm birth, and the indirect path from perceived conditions through distress to preterm birth was supported.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis included 101 women and only 9 preterm births, so the estimates are imprecise. Only medically low-risk pregnancies were enrolled, so it says little about higher-risk patients; the study preterm birth rate was 8.9%, compared with 16.3% in national data for pregnant African American women. Participants were mostly young and single African American women recruited from one Chicago medical center, so results may not apply to older women, other racial groups, or other neighborhoods. Objective neighborhood measures used a 0.5-mile buffer and administrative data, which may not match what women experienced; length of residence in the neighborhood was not measured. Perceived neighborhood measures and distress were reported by the same women, so distress may have colored reports of neighborhood problems. Secondhand smoke was not measured, although it can increase preterm birth risk. A post hoc power analysis suggested the study was slightly underpowered.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that living in a disorderly or high-crime neighborhood causes preterm birth. This was an observational study of 101 women with only 9 preterm births, and objective neighborhood data were not related to distress or preterm birth.