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Socioeconomic status, neighborhood social conditions, and neural tube defects.

CPQCC Publication
TitleSocioeconomic status, neighborhood social conditions, and neural tube defects.
Publication TypeJournal Article
Year of Publication1998
AuthorsWasserman CR, Shaw GM, Selvin S, Gould JB, Syme SL
JournalAm J Public Health
Date Published1998 Nov
KeywordsAdult, 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 JournalAm J Public Health
PubMed ID9807535
PubMed Central IDPMC1508558