Presenting Author: Stephanie Mayne, MHS, PhD, Northwestern University Feinberg School of Medicine

ABSTRACT

Background: Adverse pregnancy outcomes increase infants' risk of future health problems and are associated with higher cardiovascular disease risk among mothers. Neighborhood crime may contribute to adverse pregnancy outcomes by increasing chronic stress, yet associations have been understudied relative to other exposures such as neighborhood deprivation.

Objectives: To evaluate associations of neighborhood crime rates with adverse pregnancy outcomes among women from 77 neighborhoods in Chicago.

Methods: Electronic medical records from 41,778 singleton births at Northwestern University's Prentice Women's Hospital from 2009-2013 were geocoded and linked to one-year rates of police-recorded crime at the neighborhood (Chicago community area) level. Cross-sectional associations of neighborhood crime rates with hypertension in pregnancy (pre-eclampsia/gestational hypertension, HIP), preterm birth (PTB), and small for gestational age (SGA) birth were assessed using multilevel logistic regression models with community area random intercepts. Models controlled for maternal and infant characteristics (mother’s age at delivery, race/ethnicity, insurance status, multiparity, gestational diabetes, medical history, substance abuse, infant sex) and neighborhood poverty.

Results: Neighborhood crime rates ranged from 11.6 to 303.5 incidents per 1,000 persons per year (mean: 59.8, SD: 39.2). A 1-SD increase in neighborhood crime rate was associated with higher odds of HIP (OR: 1.06, 95% CI: 1.00, 1.13), PTB (OR: 1.09, 95% CI: 1.03, 1.14), and SGA (OR: 1.05, 95% CI: 1.01, 1.10) in fully adjusted models.

Implications:Higher neighborhood crime rates were associated with small but significant increases in the odds of adverse pregnancy outcomes. Interventions that cultivate safer neighborhoods may be a promising approach for improving pregnancy outcomes.

Authors: Stephanie Mayne, MHS, PhD; Lindsay Pool, BA, MPH, PhD; and Kiarri Kershaw, PhD, MPH.