Neighbourhood Deprivation and Small-for-Gestational-Age Term Births in the United States

Abstract

Summary: 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.