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. 2023 Jul 1;34(4):576-588.
doi: 10.1097/EDE.0000000000001621. Epub 2023 May 30.

Neighborhood-level Socioeconomic Position During Early Pregnancy and Risk of Gastroschisis

Dayna T Neo  1 , Tania A Desrosiers  1 , Chantel L Martin  1   2 , Suzan L Carmichael  3   4 , Muge Gucsavas-Calikoglu  5 , Kristin M Conway  6 , Shannon Pruitt Evans  7   8 , Marcia L Feldkamp  9 , Suzanne M Gilboa  7 , Tabassum Z Insaf  10   11 , Fadi I Musfee  12   13 , Gary M Shaw  3 , Charles J Shumate  14 , Martha M Werler  15 , Andrew F Olshan  2 ; National Birth Defects Prevention Study
Affiliations

Neighborhood-level Socioeconomic Position During Early Pregnancy and Risk of Gastroschisis

Dayna T Neo et al. Epidemiology. .

Abstract

Background: Neighborhood-level socioeconomic position has been shown to influence birth outcomes, including selected birth defects. This study examines the un derstudied association between neighborhood-level socioeconomic position during early pregnancy and the risk of gastroschisis, an abdominal birth defect of increasing prevalence.

Methods: We conducted a case-control study of 1,269 gastroschisis cases and 10,217 controls using data from the National Birth Defects Prevention Study (1997-2011). To characterize neighborhood-level socioeconomic position, we conducted a principal component analysis to construct two indices-Neighborhood Deprivation Index (NDI) and Neighborhood Socioeconomic Position Index (nSEPI). We created neighborhood-level indices using census socioeconomic indicators corresponding to census tracts associated with addresses where mothers lived the longest during the periconceptional period. We used generalized estimating equations to estimate odds ratios (ORs) and 95% confidence intervals (CIs), with multiple imputations for missing data and adjustment for maternal race-ethnicity, household income, education, birth year, and duration of residence.

Results: Mothers residing in moderate (NDI Tertile 2 aOR = 1.23; 95% CI = 1.03, 1.48 and nSEPI Tertile 2 aOR = 1.24; 95% CI = 1.04, 1.49) or low socioeconomic neighborhoods (NDI Tertile 3 aOR = 1.28; 95% CI = 1.05, 1.55 and nSEPI Tertile 3 aOR = 1.32, 95% CI = 1.09, 1.61) were more likely to deliver an infant with gastroschisis compared with mothers residing in high socioeconomic neighborhoods.

Conclusions: Our findings suggest that lower neighborhood-level socioeconomic position during early pregnancy is associated with elevated odds of gastroschisis. Additional epidemiologic studies may aid in confirming this finding and evaluating potential mechanisms linking neighborhood-level socioeconomic factors and gastroschisis.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1.
Figure 1.
Study population
Figure 2.
Figure 2.
Distribution of Neighborhood Deprivation Index (NDI) and Neighborhood Socioeconomic Position Index (nSEPI), National Birth Defects Prevention Study, 1997 – 2011
Figure 3.
Figure 3.
Simplified directed acyclic graph (DAG) for the association between neighborhood-level socioeconomic position during early pregnancy and risk of gastroschisis
Figure 4.
Figure 4.
Distribution of Neighborhood Deprivation Index (NDI) and Neighborhood Socioeconomic Position Index (nSEPI) by maternal race/ethnicity, National Birth Defects Prevention Study, 1997 – 2011
FIGURE 5.
FIGURE 5.
Crude and adjusted odds ratios (95% confidence intervals) for the association between (A) Neighborhood Deprivation Index (NDI) (B) Neighborhood Socioeconomic Position Index (nSEPI), and gastroschisis. Adjusted for maternal race/ethnicity, education, household income, birth year, and duration of residence.
See this image and copyright information in PMC

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