Margerison-Zilko Claire, Cubbin Catherine, Jun Jina, Marchi Kristen, Fingar Kathryn, Braveman Paula
Claire Margerison-Zilko is with the Department of Epidemiology and Biostatistics, Michigan State University, East Lansing. Catherine Cubbin is with the School of Social Work and the Population Research Center, University of Texas, Austin. Jina Jun is with the Health Policy Research Department, Korea Institute for Health and Social Affairs, Seoul, Korea. Kristen Marchi, Kathryn Fingar, and Paula Braveman are with the Department of Family and Community Medicine, University of California, San Francisco.
Am J Public Health. 2015 Jun;105(6):1174-80. doi: 10.2105/AJPH.2014.302441. Epub 2015 Apr 16.
We examined associations between longitudinal neighborhood poverty trajectories and preterm birth (PTB).
Using data from the Neighborhood Change Database (1970-2000) and the American Community Survey (2005-2009), we categorized longitudinal trajectories of poverty for California neighborhoods (i.e., census tracts). Birth data included 23 291 singleton California births from the Maternal and Infant Health Assessment (2003-2009). We estimated associations (adjusted for individual-level covariates) between PTB and longitudinal poverty trajectories and compared these to associations using traditional, cross-sectional measures of poverty.
Compared to neighborhoods with long-term low poverty, those with long-term high poverty and those that experienced increasing poverty early in the study period had 41% and 37% increased odds of PTB (95% confidence interval [CI] = 1.18, 1.69 and 1.09, 1.72, respectively). High (compared with low) cross-sectional neighborhood poverty was not associated with PTB (odds ratio = 1.08; 95% CI = 0.91, 1.28).
Neighborhood poverty histories may contribute to an understanding of perinatal health and should be considered in future research.
我们研究了邻里贫困纵向轨迹与早产（PTB）之间的关联。
利用邻里变化数据库（1970 - 2000年）和美国社区调查（2005 - 2009年）的数据，我们对加利福尼亚州邻里（即人口普查区）的贫困纵向轨迹进行了分类。出生数据包括来自母婴健康评估（2003 - 2009年）的23291例加利福尼亚州单胎出生。我们估计了早产与贫困纵向轨迹之间的关联（针对个体层面的协变量进行了调整），并将这些关联与使用传统横断面贫困指标得出的关联进行了比较。
与长期贫困程度低的邻里相比，长期贫困程度高的邻里以及在研究初期贫困程度上升的邻里早产几率分别增加了41%和37%（95%置信区间[CI]分别为1.18, 1.69和1.09, 1.72）。邻里横断面贫困程度高（与低相比）与早产无关联（优势比 = 1.08；95% CI = 0.91, 1.28）。
邻里贫困历史可能有助于理解围产期健康，未来研究应予以考虑。
