Neighborhood Food Access and Birth Outcomes in South Carolina.

Abstract

Evidence of the association between food environment and birth outcomes is limited. This study aimed to examine the association between individual-level food access measures and birth outcomes. All birth certificates (N=15,786) from January 1, 2008 to December 31, 2009 in eight counties in South Carolina were included. Access to food was evaluated by the distance to the nearest food store and the number of each type of store within a 1-mile (1.6-km) radius from the women's homes. Birth outcomes included birth weight, low birth weight, gestational age, and preterm birth (PTB). A further distance to the nearest convenience store was associated with higher birth weight and gestational age. Birth weight in areas with two or more convenience stores within a 1-mile (1.6-km) buffer was less [two stores: β=-46.2, 95% confidence interval (CI) -76.5, -15.9; three or more stores: β=-48.6, 95% CI -78.8, -18.5], and gestational age was shorter in areas with one or two convenience stores (one store: β=-0.11, 95% CI -0.21, -0.00; two or more stores: β=-0.13, 95% CI -0.25, 0.00) than in areas without convenience stores in the neighborhood. Having three or more convenience stores in the neighborhood was associated with increased risk of PTB compared with no convenience stores. Accessibility and availability of supermarkets and grocery stores were not associated with any birth outcomes. This analysis suggests that access to unhealthy foods is associated with adverse birth outcomes. Future investigations with more comprehensive measures of food environment are warranted.