Neighborhood Deprivation and Preterm Birth among Non-Hispanic Black and White Women in Eight Geographic Areas in the United States

Disparities in preterm birth by race and ethnic group have been demonstrated in the United States. Recent research has focused on the impact of neighborhood context on racial disparities in pregnancy outcomes. The authors utilized vital-record birth certificate data and US Census data from eight geographic areas in four states (Maryland, Michigan, North Carolina, and Pennsylvania) to examine the relation between neighborhood deprivation and preterm birth among non-Hispanic White and Black women. The years covered by the data varied by site and ranged from 1995 to 2001. Results were adjusted for maternal age and education, and specific attention was paid to racial and geographic differences in the relation between neighborhood deprivation and preterm birth. Preterm birth rates were higher for non-Hispanic Blacks (10.42-15.97%) than for non-Hispanic Whites (5.77-9.13%), and neighborhood deprivation index values varied substantially across the eight areas. A significant association was found between neighborhood deprivation and risk of preterm birth; for the first quintile of the deprivation index versus the fifth, the adjusted summary odds ratio was 1.57 (95% confidence interval: 1.41, 1.74) for non-Hispanic Whites and 1.15 (95% confidence interval: 1.08, 1.23) for non-Hispanic Blacks. In this study, deprivation at the neighborhood level was significantly associated with increased risk of preterm birth among both non-Hispanic White women and non-Hispanic Black women.