|Title||Socioeconomic status, neighborhood social conditions, and neural tube defects.|
|Publication Type||Journal Article|
|Year of Publication||1998|
|Authors||Wasserman CR, Shaw GM, Selvin S, Gould JB, Syme SL|
|Journal||Am J Public Health|
|Date Published||1998 Nov|
|Keywords||Adult, California, Case-Control Studies, Continental Population Groups, Female, Humans, Neural Tube Defects, Nutritional Status, Odds Ratio, Poverty, Pregnancy, Residence Characteristics, Risk Factors, Social Conditions, Surveys and Questionnaires|
OBJECTIVES: This study evaluated the contributions of lower socioeconomic status (SES) and neighborhood socioeconomic characteristics to neural tube defect etiology. The influence of additional factors, including periconceptional multivitamin use and race/ethnicity, was also explored.
METHODS: Data derived from a case-control study of California pregnancies from 1989 to 1991. Mothers of 538 (87.8% of eligible) case infants/fetuses with neural tube defects and mothers of 539 (88.2%) nonmalformed infants were interviewed about their SES. Reported addresses were linked to 1990 US census information to characterize neighborhoods.
RESULTS: Twofold elevated risks were observed for several SES indicators. Risks were somewhat confounded by vitamin use, race/ethnicity, age, body mass index, and fever but remained elevated after adjustment. A risk gradient was seen with increasing number of lower SES indicators. Women with 1 to 3 and 4 to 6 lower SES indicators had adjusted odds ratios of 1.6 (1.1-2.2) and 3.2 (1.9-5.4), respectively, compared with women with no lower SES indicators.
CONCLUSIONS: Both lower SES and residence in a SES-lower neighborhood increased the risk of an neural tube defect-affected pregnancy, with risks increasing across a gradient of SES indicators.
|Alternate Journal||Am J Public Health|
|PubMed Central ID||PMC1508558|