482: Neighborhood violent crime is associated with high perceived stress in pregnancy

Abstract

Stress can adversely affect pregnancy outcomes. However, stress measures are not readily available for large population-based registries. While neighborhood measures of social stressors, such as violence, are publically accessible, whether they correlate with perceived stress in pregnancy is unknown. We sought to determine whether neighborhood violent crime rates were associated with perceived stress in a largely minority, urban pregnancy cohort. From the Motherhood & Microbiome cohort (n=2000), we performed a secondary analysis of 1,309 Philadelphia residents for whom neighborhood violent crime and Cohen’s Perceived Stress Scale (PSS-14) data were available. We downloaded violent crime data (aggravated assault with and without firearm, robbery with and without firearm, rape, and homicide) from the City of Philadelphia and calculated annual census tract rates per 10,000 residents. We then dichotomized PSS at a score of 30. We used log-binomial regression models to calculate risk ratios of high stress per IQR increment of violent crime. Demographics are presented in Table 1. Young, black, obese, and single women lived in neighborhoods with higher levels of violent crime. Young, black, smoking, and single women were more likely to have high stress. Violent crime rates and stress scores were weakly, but significantly correlated (r= 0.14, P < 0.0001). Unadjusted associations between crime and high stress were significant (RR 1.34, 95% CI: 1.18-1.51) (Table 2). After consideration of potential confounding variables, only adjustment for race/ethnicity substantially attenuated the results (RR 1.17, 95% CI: 1.00-1.35) (P=0.045), yet race-stratified models had similar magnitudes of association between crime and stress as unadjusted models. Neighborhood violent crime exposure may contribute to stress in pregnancy. Our study identified one potential area-level stressor that may be used in large epidemiologic pregnancy studies when personal-level stress data are not available.View Large Image Figure ViewerDownload Hi-res image Download (PPT)