Urban violence and African-American pregnancy outcome: an ecologic study.

OBJECTIVES

To ascertain the extent to which residence in violent communities is an independent risk factor for adverse pregnancy outcomes among impoverished (census tract median family income < $10,000/year) African-American mothers.

DESIGN

A cross-sectional study was performed.

METHODS

We performed multivariate analyses on 1983 Illinois vital records, Chicago Police Department violent crime rates, and 1980 United States Census income data.

RESULTS

African-American mothers who resided in the most violent communities had a low birth weight rate of 16% compared to 12% for infants (N = 315) with mothers who lived in the least violent communities; odds ratio = 1.5 (1.0-2.1). The proportion of small-for-gestational-age infants was substantially elevated in mothers who resided in the most violent communities compared to mothers who lived in the least violent communities: 7% vs. 3%; odds ratio = 2.6 (1.5-2.1). In multivariate logistic regression models that controlled for individual risk factors, the adjusted odds ratios for low birth weight and small-for-gestational-age infants among mothers who resided in the most (compared to the least) violent communities were 1.1 (0.9-1.2) and 1.5 (1.1-2.1), respectively.

CONCLUSION

We conclude that a community's violent crime rate is associated with intrauterine growth retardation among infants born to African-American women.