Neighborhood socioeconomic status, maternal race and preterm delivery: A case-control study

PURPOSE: To explore associations between neighborhood socioeconomic context and preterm deliver, independent of maternal and family socioeconomic status, in African-American and white women. METHODS: A case-control study of African-American (n = 417) and white (n = 1244) women delivering infants, at the University of California, San Francisco's Moffitt Hospital, between 1980 and 1990. RESULTS: Neighborhood socioeconomic contexts were associated with preterm delivery but associations were non-linear and varied with race/ethnicity. For African-American women, living in a neighborhood with either high or low median household income was associated with in increased risk of spontaneous preterm delivery, as was living in a neighborhood with large increases or decreases in the proportion of African-American residents during the study decade. Residence in neighborhoods with high and tow rates of male unemployment was associated with a decreased risk of preterm delivery Among white women only large positive and negative changes in neighborhood male unemployment were associated with risk of preterm delivery. CONCLUSIONS: Neighborhood factors and changes in neighborhoods over time are related to preterm delivery, although the mechanisms linking local environments to maternal risk remain to he specified.