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 |
Volume | 88 |
Issue | 11 |
Pagination | 1674-80 |
Date Published | 1998 Nov |
ISSN | 0090-0036 |
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 |
Abstract | 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. |
DOI | 10.2105/ajph.88.11.1674 |
Alternate Journal | Am J Public Health |
PubMed ID | 9807535 |
PubMed Central ID | PMC1508558 |