ABSTRACT Background Previous research has shown an association between neighbourhood context and adverse birth outcomes, but with high heterogeneity. Objective To examine the degree to which social support buffers against the adverse effects of neighbourhood deprivation on preterm birth and small for gestational age (SGA). Methods This study is a secondary analysis of data from the nuMoM2b (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers‐To‐Be) longitudinal cohort study, which recruited participants between 2010 and 2013. We estimated prevalence differences (PD) for area deprivation index (ADI) and for social support with each adverse birth outcome, and we evaluated whether the effect of ADI was modified by perceived social support; we additionally stratified by race/ethnicity. All models were adjusted for maternal age and education. Results Our analytic sample included n = 8377 participants. Among the birth outcomes we investigated, high social support had the strongest association with preterm birth. Participants reporting high social support had three fewer cases of preterm birth per 100 pregnancies (PD = −0.03, 95% CI −0.05, 0.00), compared to participants reporting low or moderate social support. The only evidence of high social support buffering against the harmful effects of neighbourhood deprivation was seen with SGA. Among participants with low or moderate social support, a 25‐percentile increase in ADI was associated with two excess cases of SGA per 100 pregnancies (PD = 0.02, 95% CI −0.01, 0.04); whereas among participants with high social support, there was a null effect (PD = 0.00, 95% CI −0.01, 0.01). This effect modification was seen mostly among non‐Hispanic White individuals. Conclusion Social support might offer some protection against the effects of neighbourhood deprivation on SGA, perhaps more so for non‐Hispanic White people. However, we did not find evidence of social support buffering against the effects of neighbourhood deprivation on preterm birth.
Dixon et al. (Sun,) studied this question.