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Environmental variables as potential modifiable risk factors of preterm birth in Philadelphia, PA

  • Jamie A. Bastek
    Correspondence
    Corresponding author: Jamie A. Bastek, MD, MSCE.
    Affiliations
    Maternal and Child Health Research Program, Department of Obstetrics and Gynecology, Center for Research on Reproduction and Women’s Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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  • Mary D. Sammel
    Affiliations
    Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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  • Tara D. Jackson
    Affiliations
    Cartographic Modeling Lab, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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  • Meghan E. Ryan
    Affiliations
    Maternal and Child Health Research Program, Department of Obstetrics and Gynecology, Center for Research on Reproduction and Women’s Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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  • Meghan A. McShea
    Affiliations
    Maternal and Child Health Research Program, Department of Obstetrics and Gynecology, Center for Research on Reproduction and Women’s Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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  • Michal A. Elovitz
    Affiliations
    Maternal and Child Health Research Program, Department of Obstetrics and Gynecology, Center for Research on Reproduction and Women’s Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Published:September 04, 2014DOI:https://doi.org/10.1016/j.ajog.2014.08.025

      Objective

      To examine whether variation in neighborhood context is associated with preterm birth (PTB) outcomes and gestational age (GA) at delivery in Philadelphia, and to determine whether these associations might persist when considering relevant individual-level variables.

      Study Design

      We analyzed individual-level data collected for a prospective cohort study of singleton pregnancies with preterm labor. We merged block-group level data to each individual's home address. Unadjusted analyses were performed to determine the association between block-group variables and individual-level outcomes. Block-group variables identified as potential risk factors were incorporated into multivariable individual-level models to determine significance.

      Results

      We analyzed data for 817 women. The prevalence of PTB <37 weeks was 41.5%. Although in unadjusted analyses several block-group variables were associated with PTB and GA at delivery, none retained significance in individual-level multivariable models.

      Conclusion

      Block-group level data were not associated with PTB outcomes or GA at delivery in Philadelphia.

      Key words

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