Racial and geographic variation in effects of maternal education and neighborhood-level measures of socioeconomic status on gestational age at birth: Findings from the ECHO cohorts.
Preterm birth occurs at excessively high and disparate rates in the United States. In 2016, the National Institutes of Health (NIH) launched the Environmental influences on Child Health Outcomes (ECHO) program to investigate the influence of early life exposures on child health. Extant data from the...
Guardado en:
| Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Public Library of Science (PLoS)
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/6bb755a58aba4dd7b5508c0df7a9ea19 |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:6bb755a58aba4dd7b5508c0df7a9ea19 |
|---|---|
| record_format |
dspace |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Anne L Dunlop Alicynne Glazier Essalmi Lyndsay Alvalos Carrie Breton Carlos A Camargo Whitney J Cowell Dana Dabelea Stephen R Dager Cristiane Duarte Amy Elliott Raina Fichorova James Gern Monique M Hedderson Elizabeth Hom Thepaksorn Kathi Huddleston Margaret R Karagas Ken Kleinman Leslie Leve Ximin Li Yijun Li Augusto Litonjua Yunin Ludena-Rodriguez Juliette C Madan Julio Mateus Nino Cynthia McEvoy Thomas G O'Connor Amy M Padula Nigel Paneth Frederica Perera Sheela Sathyanarayana Rebecca J Schmidt Robert T Schultz Jessica Snowden Joseph B Stanford Leonardo Trasande Heather E Volk William Wheaton Rosalind J Wright Monica McGrath program collaborators for Environmental Influences on Child Health Outcomes Racial and geographic variation in effects of maternal education and neighborhood-level measures of socioeconomic status on gestational age at birth: Findings from the ECHO cohorts. |
| description |
Preterm birth occurs at excessively high and disparate rates in the United States. In 2016, the National Institutes of Health (NIH) launched the Environmental influences on Child Health Outcomes (ECHO) program to investigate the influence of early life exposures on child health. Extant data from the ECHO cohorts provides the opportunity to examine racial and geographic variation in effects of individual- and neighborhood-level markers of socioeconomic status (SES) on gestational age at birth. The objective of this study was to examine the association between individual-level (maternal education) and neighborhood-level markers of SES and gestational age at birth, stratifying by maternal race/ethnicity, and whether any such associations are modified by US geographic region. Twenty-six ECHO cohorts representing 25,526 mother-infant pairs contributed to this disseminated meta-analysis that investigated the effect of maternal prenatal level of education (high school diploma, GED, or less; some college, associate's degree, vocational or technical training [reference category]; bachelor's degree, graduate school, or professional degree) and neighborhood-level markers of SES (census tract [CT] urbanicity, percentage of black population in CT, percentage of population below the federal poverty level in CT) on gestational age at birth (categorized as preterm, early term, full term [the reference category], late, and post term) according to maternal race/ethnicity and US region. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CIs). Cohort-specific results were meta-analyzed using a random effects model. For women overall, a bachelor's degree or above, compared with some college, was associated with a significantly decreased odds of preterm birth (aOR 0.72; 95% CI: 0.61-0.86), whereas a high school education or less was associated with an increased odds of early term birth (aOR 1.10, 95% CI: 1.00-1.21). When stratifying by maternal race/ethnicity, there were no significant associations between maternal education and gestational age at birth among women of racial/ethnic groups other than non-Hispanic white. Among non-Hispanic white women, a bachelor's degree or above was likewise associated with a significantly decreased odds of preterm birth (aOR 0.74 (95% CI: 0.58, 0.94) as well as a decreased odds of early term birth (aOR 0.84 (95% CI: 0.74, 0.95). The association between maternal education and gestational age at birth varied according to US region, with higher levels of maternal education associated with a significantly decreased odds of preterm birth in the Midwest and South but not in the Northeast and West. Non-Hispanic white women residing in rural compared to urban CTs had an increased odds of preterm birth; the ability to detect associations between neighborhood-level measures of SES and gestational age for other race/ethnic groups was limited due to small sample sizes within select strata. Interventions that promote higher educational attainment among women of reproductive age could contribute to a reduction in preterm birth, particularly in the US South and Midwest. Further individual-level analyses engaging a diverse set of cohorts are needed to disentangle the complex interrelationships among maternal education, neighborhood-level factors, exposures across the life course, and gestational age at birth outcomes by maternal race/ethnicity and US geography. |
| format |
article |
| author |
Anne L Dunlop Alicynne Glazier Essalmi Lyndsay Alvalos Carrie Breton Carlos A Camargo Whitney J Cowell Dana Dabelea Stephen R Dager Cristiane Duarte Amy Elliott Raina Fichorova James Gern Monique M Hedderson Elizabeth Hom Thepaksorn Kathi Huddleston Margaret R Karagas Ken Kleinman Leslie Leve Ximin Li Yijun Li Augusto Litonjua Yunin Ludena-Rodriguez Juliette C Madan Julio Mateus Nino Cynthia McEvoy Thomas G O'Connor Amy M Padula Nigel Paneth Frederica Perera Sheela Sathyanarayana Rebecca J Schmidt Robert T Schultz Jessica Snowden Joseph B Stanford Leonardo Trasande Heather E Volk William Wheaton Rosalind J Wright Monica McGrath program collaborators for Environmental Influences on Child Health Outcomes |
| author_facet |
Anne L Dunlop Alicynne Glazier Essalmi Lyndsay Alvalos Carrie Breton Carlos A Camargo Whitney J Cowell Dana Dabelea Stephen R Dager Cristiane Duarte Amy Elliott Raina Fichorova James Gern Monique M Hedderson Elizabeth Hom Thepaksorn Kathi Huddleston Margaret R Karagas Ken Kleinman Leslie Leve Ximin Li Yijun Li Augusto Litonjua Yunin Ludena-Rodriguez Juliette C Madan Julio Mateus Nino Cynthia McEvoy Thomas G O'Connor Amy M Padula Nigel Paneth Frederica Perera Sheela Sathyanarayana Rebecca J Schmidt Robert T Schultz Jessica Snowden Joseph B Stanford Leonardo Trasande Heather E Volk William Wheaton Rosalind J Wright Monica McGrath program collaborators for Environmental Influences on Child Health Outcomes |
| author_sort |
Anne L Dunlop |
| title |
Racial and geographic variation in effects of maternal education and neighborhood-level measures of socioeconomic status on gestational age at birth: Findings from the ECHO cohorts. |
| title_short |
Racial and geographic variation in effects of maternal education and neighborhood-level measures of socioeconomic status on gestational age at birth: Findings from the ECHO cohorts. |
| title_full |
Racial and geographic variation in effects of maternal education and neighborhood-level measures of socioeconomic status on gestational age at birth: Findings from the ECHO cohorts. |
| title_fullStr |
Racial and geographic variation in effects of maternal education and neighborhood-level measures of socioeconomic status on gestational age at birth: Findings from the ECHO cohorts. |
| title_full_unstemmed |
Racial and geographic variation in effects of maternal education and neighborhood-level measures of socioeconomic status on gestational age at birth: Findings from the ECHO cohorts. |
| title_sort |
racial and geographic variation in effects of maternal education and neighborhood-level measures of socioeconomic status on gestational age at birth: findings from the echo cohorts. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/6bb755a58aba4dd7b5508c0df7a9ea19 |
| work_keys_str_mv |
AT anneldunlop racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT alicynneglazieressalmi racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT lyndsayalvalos racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT carriebreton racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT carlosacamargo racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT whitneyjcowell racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT danadabelea racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT stephenrdager racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT cristianeduarte racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT amyelliott racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT rainafichorova racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT jamesgern racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT moniquemhedderson racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT elizabethhomthepaksorn racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT kathihuddleston racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT margaretrkaragas racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT kenkleinman racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT leslieleve racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT ximinli racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT yijunli racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT augustolitonjua racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT yuninludenarodriguez racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT juliettecmadan racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT juliomateusnino racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT cynthiamcevoy racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT thomasgoconnor racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT amympadula racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT nigelpaneth racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT fredericaperera racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT sheelasathyanarayana racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT rebeccajschmidt racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT roberttschultz racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT jessicasnowden racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT josephbstanford racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT leonardotrasande racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT heatherevolk racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT williamwheaton racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT rosalindjwright racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT monicamcgrath racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts AT programcollaboratorsforenvironmentalinfluencesonchildhealthoutcomes racialandgeographicvariationineffectsofmaternaleducationandneighborhoodlevelmeasuresofsocioeconomicstatusongestationalageatbirthfindingsfromtheechocohorts |
| _version_ |
1718374530752184320 |
| spelling |
oai:doaj.org-article:6bb755a58aba4dd7b5508c0df7a9ea192021-12-02T20:15:50ZRacial and geographic variation in effects of maternal education and neighborhood-level measures of socioeconomic status on gestational age at birth: Findings from the ECHO cohorts.1932-620310.1371/journal.pone.0245064https://doaj.org/article/6bb755a58aba4dd7b5508c0df7a9ea192021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0245064https://doaj.org/toc/1932-6203Preterm birth occurs at excessively high and disparate rates in the United States. In 2016, the National Institutes of Health (NIH) launched the Environmental influences on Child Health Outcomes (ECHO) program to investigate the influence of early life exposures on child health. Extant data from the ECHO cohorts provides the opportunity to examine racial and geographic variation in effects of individual- and neighborhood-level markers of socioeconomic status (SES) on gestational age at birth. The objective of this study was to examine the association between individual-level (maternal education) and neighborhood-level markers of SES and gestational age at birth, stratifying by maternal race/ethnicity, and whether any such associations are modified by US geographic region. Twenty-six ECHO cohorts representing 25,526 mother-infant pairs contributed to this disseminated meta-analysis that investigated the effect of maternal prenatal level of education (high school diploma, GED, or less; some college, associate's degree, vocational or technical training [reference category]; bachelor's degree, graduate school, or professional degree) and neighborhood-level markers of SES (census tract [CT] urbanicity, percentage of black population in CT, percentage of population below the federal poverty level in CT) on gestational age at birth (categorized as preterm, early term, full term [the reference category], late, and post term) according to maternal race/ethnicity and US region. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CIs). Cohort-specific results were meta-analyzed using a random effects model. For women overall, a bachelor's degree or above, compared with some college, was associated with a significantly decreased odds of preterm birth (aOR 0.72; 95% CI: 0.61-0.86), whereas a high school education or less was associated with an increased odds of early term birth (aOR 1.10, 95% CI: 1.00-1.21). When stratifying by maternal race/ethnicity, there were no significant associations between maternal education and gestational age at birth among women of racial/ethnic groups other than non-Hispanic white. Among non-Hispanic white women, a bachelor's degree or above was likewise associated with a significantly decreased odds of preterm birth (aOR 0.74 (95% CI: 0.58, 0.94) as well as a decreased odds of early term birth (aOR 0.84 (95% CI: 0.74, 0.95). The association between maternal education and gestational age at birth varied according to US region, with higher levels of maternal education associated with a significantly decreased odds of preterm birth in the Midwest and South but not in the Northeast and West. Non-Hispanic white women residing in rural compared to urban CTs had an increased odds of preterm birth; the ability to detect associations between neighborhood-level measures of SES and gestational age for other race/ethnic groups was limited due to small sample sizes within select strata. Interventions that promote higher educational attainment among women of reproductive age could contribute to a reduction in preterm birth, particularly in the US South and Midwest. Further individual-level analyses engaging a diverse set of cohorts are needed to disentangle the complex interrelationships among maternal education, neighborhood-level factors, exposures across the life course, and gestational age at birth outcomes by maternal race/ethnicity and US geography.Anne L DunlopAlicynne Glazier EssalmiLyndsay AlvalosCarrie BretonCarlos A CamargoWhitney J CowellDana DabeleaStephen R DagerCristiane DuarteAmy ElliottRaina FichorovaJames GernMonique M HeddersonElizabeth Hom ThepaksornKathi HuddlestonMargaret R KaragasKen KleinmanLeslie LeveXimin LiYijun LiAugusto LitonjuaYunin Ludena-RodriguezJuliette C MadanJulio Mateus NinoCynthia McEvoyThomas G O'ConnorAmy M PadulaNigel PanethFrederica PereraSheela SathyanarayanaRebecca J SchmidtRobert T SchultzJessica SnowdenJoseph B StanfordLeonardo TrasandeHeather E VolkWilliam WheatonRosalind J WrightMonica McGrathprogram collaborators for Environmental Influences on Child Health OutcomesPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 1, p e0245064 (2021) |