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Research article
Associations between neighborhood violence during pregnancy and birth outcomes: Evidence from São Paulo’s Western Region Birth Cohort
Angélica Carreira dos Santos
Universidade de São Paulo Faculdade de Medicina
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3937-0258
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This work is licensed under a CC BY 4.0 License. Read Full License
Background: Low birth weight and prematurity remain leading causes of infant mortality and morbidity globally. Although extensive literature has highlighted the importance of socioenvironmental characteristics for birth outcomes, the role of indirect violence on health remains fairly understudied.
Methods: Using geocoded birth records from the ongoing Western Region Birth Cohort (Região Oeste Coorte – ROC-Cohort) of infants born between 2012-2014 and geocoded crime reports, we assessed the associations between exposure to violent crimes during pregnancy within a 1-km radius of the mother’s residence and low birth weight, preterm delivery, and being born small-for-gestational-age. Violent crime exposure was categorized into quintiles. Multivariate logistic regressions were used to examine the associations between violence exposure and birth outcomes. Models were adjusted for sex, maternal age and education, socioeconomic status, and risk factors such as hypertension, diabetes, smoking, and drinking during pregnancy.
Results: Among the 5,268 infants included, the average crime exposure during the first two trimesters of pregnancy ranged from 0.44 violent crimes in the least exposed quintile to 12.74 crimes in the most exposed. Compared to children with the lowest violence exposure, children in the highest exposure quintile had higher odds of being born small-for-gestational-age (1.41[1.06-1.89]), preterm (1.35[1.01-1.80]), and low birth weight (1.42[1.03-1.98]). While socioeconomic status and maternal education were positively associated with lower violence exposure, no associations were found between these characteristics and birth outcomes.
Conclusions: Higher exposure to violent crimes in the close vicinity of pregnant women’s residence is associated with substantial increases in the odds of adverse birth outcomes. Policies to improve neighborhood safety can potentially contribute not only to the short-term wellbeing of populations but may also have large social, economic, and health benefits in the long term.
Keywords
Violence, pregnancy, child health, birth weight, social determinants of health
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This is a list of supplementary files associated with this preprint. Click to download.
- SupplementaryMaterial.docx
- Supplementaryfile1.docx
Supplementary file 1: Postpartum questionnaire.
- SupplementaryFile2v2.docx
Supplementary file 2: Multiple imputations
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CURRENT STATUS: Under Review
Version 2
Posted 06 Jan, 2021
No community comments so far
Review #1 received
Received 17 Dec, 2020
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On 16 Dec, 2020
Reviewers invited
Invitations sent on 16 Dec, 2020
Reviewer #1 agreed
On 16 Dec, 2020
Submission checks complete
On 16 Dec, 2020
Editor invited
On 16 Dec, 2020
No comments provided
Editorial decision: Major revision
On 16 Nov, 2020
Review #1 received
Received 09 Nov, 2020
Review #2 received
Received 07 Nov, 2020
Reviewer #2 agreed
On 11 Oct, 2020
Reviewer #1 agreed
On 10 Oct, 2020
Reviewers invited
Invitations sent on 09 Oct, 2020
Editor assigned
On 05 Aug, 2020
Submission checks complete
On 22 Jul, 2020
Editor invited
On 18 Jul, 2020
First submitted
On 07 Jul, 2020
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This preprint is under consideration at BMC Public Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Associations between neighborhood violence during pregnancy and birth outcomes: Evidence from São Paulo’s Western Region Birth Cohort
Angélica Carreira dos Santos
Universidade de São Paulo Faculdade de Medicina
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3937-0258
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 2
Posted 06 Jan, 2021
No community comments so far
Review #1 received
Received 17 Dec, 2020
Editor assigned
On 16 Dec, 2020
Reviewers invited
Invitations sent on 16 Dec, 2020
Reviewer #1 agreed
On 16 Dec, 2020
Submission checks complete
On 16 Dec, 2020
Editor invited
On 16 Dec, 2020
No comments provided
Editorial decision: Major revision
On 16 Nov, 2020
Review #1 received
Received 09 Nov, 2020
Review #2 received
Received 07 Nov, 2020
Reviewer #2 agreed
On 11 Oct, 2020
Reviewer #1 agreed
On 10 Oct, 2020
Reviewers invited
Invitations sent on 09 Oct, 2020
Editor assigned
On 05 Aug, 2020
Submission checks complete
On 22 Jul, 2020
Editor invited
On 18 Jul, 2020
First submitted
On 07 Jul, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Low birth weight and prematurity remain leading causes of infant mortality and morbidity globally. Although extensive literature has highlighted the importance of socioenvironmental characteristics for birth outcomes, the role of indirect violence on health remains fairly understudied.
Methods: Using geocoded birth records from the ongoing Western Region Birth Cohort (Região Oeste Coorte – ROC-Cohort) of infants born between 2012-2014 and geocoded crime reports, we assessed the associations between exposure to violent crimes during pregnancy within a 1-km radius of the mother’s residence and low birth weight, preterm delivery, and being born small-for-gestational-age. Violent crime exposure was categorized into quintiles. Multivariate logistic regressions were used to examine the associations between violence exposure and birth outcomes. Models were adjusted for sex, maternal age and education, socioeconomic status, and risk factors such as hypertension, diabetes, smoking, and drinking during pregnancy.
Results: Among the 5,268 infants included, the average crime exposure during the first two trimesters of pregnancy ranged from 0.44 violent crimes in the least exposed quintile to 12.74 crimes in the most exposed. Compared to children with the lowest violence exposure, children in the highest exposure quintile had higher odds of being born small-for-gestational-age (1.41[1.06-1.89]), preterm (1.35[1.01-1.80]), and low birth weight (1.42[1.03-1.98]). While socioeconomic status and maternal education were positively associated with lower violence exposure, no associations were found between these characteristics and birth outcomes.
Conclusions: Higher exposure to violent crimes in the close vicinity of pregnant women’s residence is associated with substantial increases in the odds of adverse birth outcomes. Policies to improve neighborhood safety can potentially contribute not only to the short-term wellbeing of populations but may also have large social, economic, and health benefits in the long term.
Figure 1
Figure 2