Abstract
We examined the associations of mothers’ perception of neighborhood quality and maternal resilience with risk of preterm birth and whether maternal resilience moderated the effect of neighborhood quality perception. We analyzed data from 10,758 women with singleton births who participated in 2010–2012 Los Angeles Mommy and Baby surveys. Multilevel logistic regression models assessed the effects of mothers’ perception of neighborhood quality and maternal resilience on preterm birth (yes/no), controlling for potential confounders and economic hardship index, a city-level measure of neighborhood quality. Interaction terms were assessed for moderation. Mothers’ perception of neighborhood quality and maternal resilience were each uniquely associated with preterm birth, independent of potential confounders (p-values < 0.05). The risk of preterm birth among mothers who perceived their neighborhood as of poor quality was about 30% greater compared to mothers who perceived their neighborhood as of good quality; the risk was 12% greater among mothers with low resilience compared to those with high resilience. Effects of neighborhood quality were not modified by maternal resilience. The findings suggest that mothers’ perception of neighborhood quality and resilience are associated with the risk of preterm birth. Further research should explore whether initiatives aimed at improving neighborhood quality and women’s self-esteem may improve birth outcomes.
Highlights
Preterm births, defined as births that occurred before 37 weeks of pregnancy, are a serious health concern
We aimed to investigate whether neighborhood quality and maternal resilience are associated with the risk of preterm birth using a large population-based sample of mothers from Los
Our results suggested that controlling for potential confounders and neighborhood socioeconomic characteristics, perceived neighborhood quality and maternal resilience were each significantly associated with preterm birth outcomes
Summary
Preterm births, defined as births that occurred before 37 weeks of pregnancy, are a serious health concern. Various stressful events during pregnancy have been shown to have an impact on women’s physical, mental and emotional health and behaviors that may lead to increased risk of an adverse birth outcome [5]. These findings support that stressors during pregnancy may predispose women to preterm delivery. These stressors may include financial stress, negative life events, catastrophic events and emotional stress [5]
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