scholarly journals Built Environment and Preterm Birth

2014 ◽  
Vol 7 (3) ◽  
pp. 77-87
Author(s):  
Nikki Keene Woods ◽  
Linda Watson ◽  
An-Diep T Nguyen

Background. Preterm birth affects approximately 500,000 babies a year in the United States. One out of nine babies born in the United States deliver before 37 weeks gestation. Preterm birth can cause lifelong neurological problems, cerebral palsy, vision and hearing impairments, and developmental delay. The estimated $26 billion a year in preterm birth related costs are staggering to the health care system. Preterm-related causes of death in 2008 together accounted for 35% of all infant deaths. Methods. This paper is a review of the literature published (2006-2012) on the relationship between neighborhood environment and preterm birth. Results. Neighborhood deprivation and the neighborhood environment were associated with low-birth weight and preterm birth. Examples of neighborhood deprivation include economic deprivation, social disorder, and lack of health resources. Neighborhood environment can be described as neighborhood physical deterioration, violent crime, and group density. Conclusions. A significant association exists between the neighborhood environment and birth outcomes. More research is needed to explore interventions with a systems approach to promote healthy maternal behavior, reduce stress, and improve care for expecting mothers living in stressful neighborhood environments in order to reduce preterm births.

2020 ◽  
Vol 13 (12) ◽  
Author(s):  
Shivani A. Patel ◽  
Maya Krasnow ◽  
Kaitlyn Long ◽  
Theresa Shirey ◽  
Neal Dickert ◽  
...  

Background: Longstanding racial disparities in heart failure (HF) outcomes exist in the United States, in part, due to social determinants of health. We examined whether neighborhood environment modifies the disparity in 30-day HF readmissions and mortality between Black and White patients in the Southeastern United States. Methods: We created a geocoded retrospective cohort of patients hospitalized for acute HF within Emory Healthcare from 2010 to 2018. Quartiles of the Social Deprivation Index characterized neighborhood deprivation at the census tract level. We estimated the relative risk of 30-day readmission and 30-day mortality following an index hospitalization for acute HF. Excess readmissions and mortality were estimated as the absolute risk difference between Black and White patients within each Social Deprivation Index quartile, adjusted for geographic clustering, demographic, clinical, and hospital characteristics. Results: The cohort included 30 630 patients, mean age 66 years, 48% female, 53% Black. Compared with White patients, Black patients were more likely to reside in deprived census tracts and have higher comorbidity scores. From 2010 to 2018, 29.4% of Black and 23.0% of White patients experienced either a 30-day HF readmission or 30-day death ( P <0.001). Excess in composite 30-day HF readmissions and mortality for Black patients ranged from 3.9% (95% CI, 1.5%–6.3%; P =0.0002) to 6.8% (95% CI, 4.1%–9.5%; P <0.0001) across Social Deprivation Index quartiles. Accounting for traditional risk factors did not eliminate the Black excess in combined 30-day HF readmissions or mortality in any of the neighborhood quartiles. Conclusions: Excess 30-day HF readmissions and mortality are present among Black patients in every neighborhood strata and increase with progressive neighborhood socioeconomic deprivation.


2007 ◽  
Vol 167 (2) ◽  
pp. 155-163 ◽  
Author(s):  
P. O'Campo ◽  
J. G. Burke ◽  
J. Culhane ◽  
I. T. Elo ◽  
J. Eyster ◽  
...  

2007 ◽  
Vol 18 (1) ◽  
pp. 25-52 ◽  
Author(s):  
MANJU CHANDIRAMANI ◽  
ANDREW H SHENNAN

Preterm birth and its subsequent consequences continue to be a major challenge worldwide. In the United States in 2004, 12.5% of infants were born preterm, making the annual societal economic burden associated with preterm birth in excess of $26.2 billion (and this is a modest estimate). Spontaneous preterm birth accounts for about 75% of all preterm births; however, at earlier gestations iatrogenic preterm birth accounts for a greater proportion of all preterm births; at 27–28 weeks 50% are iatrogenic. The proportion of babies transferred to the neonatal unit is more than 90% for those born before 33 completed weeks of gestation compared with 31% at 36 weeks; delivery between 33 completed weeks and 36 completed weeks has a relatively low morbidity and mortality. Nonetheless, 1 in 3 children born preterm but beyond 32 weeks have educational and behavioural problems at the age of 7, with 1 in 4 children born between 32 and 35 weeks requiring support from non-teaching assistants at school. Although more than 40% of babies at 35 completed weeks show signs of maturity, some still need ventilation at 38 completed weeks. Almost one-fifth of all infants born at less than 32 weeks gestation do not survive the first year of life.


2007 ◽  
Vol 37 (4) ◽  
pp. 635-641 ◽  
Author(s):  
Marian F. MacDorman ◽  
William M. Callaghan ◽  
T. J. Mathews ◽  
Donna L. Hoyert ◽  
Kenneth D. Kochanek

Trends in preterm-related causes of death were examined by maternal race and ethnicity. A grouping of preterm-related causes of infant death was created by identifying causes that were a direct cause or consequence of preterm birth. Cause-of-death categories were considered to be preterm-related when 75 percent or more of total infant deaths attributed to that cause were deaths of infants born preterm, and the cause was considered to be a direct consequence of preterm birth based on a clinical evaluation and review of the literature. In 2004, 36.5 percent of all infant deaths in the United States were preterm-related, up from 35.4 percent in 1999. The preterm-related infant mortality rate for non-Hispanic black mothers was 3.5 times higher and the rate for Puerto Rican mothers was 75 percent higher than for non-Hispanic white mothers. The preterm-related infant mortality rate for non-Hispanic black mothers was higher than the total infant mortality rate for non-Hispanic white, Mexican, and Asian or Pacific Islander mothers. The leveling off of the U.S. infant mortality decline since 2000 has been attributed in part to an increase in preterm and low-birthweight births. Continued tracking of preterm-related causes of infant death will improve our understanding of trends in infant mortality in the United States.


2014 ◽  
Vol 34 (11) ◽  
pp. 823-829 ◽  
Author(s):  
D Getahun ◽  
K Demissie ◽  
S W Marcella ◽  
G G Rhoads

PEDIATRICS ◽  
1986 ◽  
Vol 77 (5) ◽  
pp. 791-792
Author(s):  
HUGH CRAFT ◽  
EARL SIEGEL

To the Editor.— It was encouraging to see the results of the recent study from France on the prevention of preterm births published in Pediatrics.1 Pediatricians have long supported preventive measures to improve infant and child health. But, pediatricians, in general, and neonatologists, in particular, have been slow to assume an advocacy position for an obvious, important preventive effort, namely, reducing the incidence of low birth weight. During the last 20 years, the United States has experienced a dramatic improvement in neonatal mortality, from rates of neonatal death of 18 per 1,000 live births in 1965 to 6.8 per 1,000 live births today.2,3


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