Association between neighbourhood deprivation, fetal growth, small-for-gestational age and preterm birth: a population-based prospective cohort study

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Abstract

Objective To study the associations between neighbourhood deprivation and fetal growth, including growth in the first trimester, and adverse pregnancy outcomes. Design Prospective cohort study. Setting The Netherlands, Rotterdam. Participants 8617 live singleton births from the Generation R cohort study. Exposition Living in a deprived neighbourhood. Main outcome measures Fetal growth trajectories of head circumference, weight and length. Secondary outcomes measures Small-for-gestational age (SGA) and preterm birth (PTB). Results Neighbourhood deprivation was not associated with first trimester growth. However, a higher neighbourhood status score (less deprivation) was associated with increased fetal growth in the second and third trimesters (eg, estimated fetal weight; adjusted regression coefficient 0.04, 95% CI 0.02 to 0.06). Less deprivation was also associated with decreased odds of SGA (adjusted OR 0.91, 95% CI 0.86 to 0.97, p=0.01) and PTB (adjusted OR 0.89, 95% CI 0.82 to 0.96, p=0.01). Conclusions We found an association between neighbourhood deprivation and fetal growth in the second and third trimester pregnancy, but not with first trimester growth. Less neighbourhood deprivation is associated with lower odds of adverse pregnancy outcomes. The associations remained after adjustment for individual-level risk factors. This supports the hypothesis that living in a deprived neighbourhood acts as an independent risk factor for fetal growth and adverse pregnancy outcomes, above and beyond individual risk factors.

Original languageEnglish
Article numbere049075
JournalBMJ Open
Volume11
Issue number11
DOIs
Publication statusPublished - 16 Nov 2021

Bibliographical note

Funding Information:
Funding The Generation R study was made possible by financial support from Erasmus MC, University Medical Center Rotterdam, the Netherlands; the Netherlands Organization for Health Research and Development; the Netherlands Organization for Scientific Research; the Ministry of Health, Welfare and Sport; and the Ministry of Youth and Families. VWVJ received additional grants from the Netherlands Organization for Health Research and Development (grants 90700303 and 916.10159, and VIDI 016.136.361) and a Consolidator Grant from the European Research Council (ERC-2014-CoG-64916).

Publisher Copyright:
© Author(s) (or their employer(s)) 2021.

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