The Impact of Neighbourhood Deprivation on Embryonic Growth Trajectories: Rotterdam Periconception Cohort.

Dionne V Gootjes,Sten P Willemsen,Régine P M Steegers-Theunissen,Eric A P Steegers,Maria P H Koster,Anton H J Koning

doi:10.3390/jcm8111913

Dionne V Gootjes, Sten P Willemsen + Show 4 more

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https://doi.org/10.3390/jcm8111913

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Abstract

Background: Neighbourhood deprivation is a risk factor for impaired health and adverse pregnancy outcomes. We investigated whether living in a deprived neighbourhood is associated with embryonic growth. Methods: From the Predict cohort, we studied 566 women who underwent repeated first trimester ultrasound examinations. Crown rump length (CRL; n = 1707) and embryonic volume (EV; n = 1462) were measured using three-dimensional techniques. Neighbourhood deprivation was assessed using the neighbourhood status scores (NSS) of the Dutch Social Cultural Planning office. A high NSS represents a non-deprived neighbourhood. Associations between the NSS and embryonic growth were investigated using linear mixed models. Adjustment was performed for individual-level factors: maternal age, geographic origin, educational level, BMI, folic acid supplement use, fruit and vegetable intake, alcohol use and smoking habits. Results: The NSS was negatively associated with embryonic growth: a higher score (a less deprived neighbourhood) was associated with a smaller CRL and EV; adjusted β: −0.025 (95% CI −0.046, −0.003) and adjusted β: −0.015 (95% CI −0.026, −0.003). At 11 weeks of pregnancy, we observed a 0.55 cm3 smaller EV (7.65 cm3 vs. 7.10 cm3) and 1.08 mm smaller CRL (43.14 mm vs. 42.06 mm) in the highest compared to the lowest category. Conclusion: In deprived neighbourhoods, embryos are larger than in non-deprived neighbourhoods.

Highlights

Residential neighbourhood environment is acknowledged as an important factor affecting health and reproductive outcomes of the population [1,2,3]
From a total of the 830 pregnancies with serial ultrasound evaluation in the Rotterdam Periconception cohort, 566 pregnancies were included in the analyses (Figure 1)
Women living in a neighbourhood with a low neighbourhood status scores (NSS) (NSS < −1; deprived neighbourhood) were less often of Western geographic origin (73.6% vs. 92.9%), were less often highly educated (58.9% vs. 77.7%) and had a higher median BMI (25.3 kg/m2 vs. 23.3 kg/m2) compared to women living in a neighbourhood with a high NSS (NSS > 1; non-deprived neighbourhood) (Table 1)

Summary

Introduction

Residential neighbourhood environment is acknowledged as an important factor affecting health and reproductive outcomes of the population [1,2,3]. Living in a deprived neighbourhood has been shown to be associated with adverse pregnancy outcomes such as preterm birth, small-for-gestational age (SGA) and perinatal mortality [4,5]. An isolated role of neighbourhood deprivation has been postulated; living in a deprived neighbourhood is considered a self-contained risk factor for impaired physical and mental health and pregnancy course and outcomes [5,7]. Neighbourhood deprivation is a risk factor for impaired health and adverse pregnancy outcomes. We investigated whether living in a deprived neighbourhood is associated with embryonic growth. Results: The NSS was negatively associated with embryonic growth: a higher score (a less deprived neighbourhood) was associated with a smaller CRL and EV; adjusted β: −0.025 (95% CI −0.046, −0.003) and adjusted β: −0.015 (95% CI −0.026, −0.003). Conclusion: In deprived neighbourhoods, embryos are larger than in non-deprived neighbourhoods

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