The Impact of Neighborhood Conditions and Psychological Distress on Preterm Birth in African‐American Women

• Published in: Public health Nursing 2017-05, Vol.34 (3), p.256-266
• Main Authors: Giurgescu, Carmen, Zenk, Shannon N., Templin, Thomas N., Engeland, Christopher G., Kavanaugh, Karen, Misra, Dawn P.
• Format: Article
• Language: English
• Subjects: Adult; African Americans; African‐American; Birth; Black or African American - psychology; Black or African American - statistics & numerical data; Chicago - epidemiology; Childbirth & labor; Crime; Cross-Sectional Studies; Female; Geographic information systems; Gestation; Health care facilities; Humans; Infant, Newborn; Medical records; Mental health; neighborhood conditions; Neighborhoods; Nursing; Pregnancy; Premature birth; Premature Birth - ethnology; preterm birth; Psychological aspects; psychological distress; Quantitative analysis; Remote sensing; Residence Characteristics - statistics & numerical data; Risk Assessment; Satellite navigation systems; Stress, Psychological - ethnology; Womens health; Young Adult
• ISSN: 0737-1209; 1525-1446
• DOI: 10.1111/phn.12305

Objective Prior research suggests that adverse neighborhood conditions are related to preterm birth. One potential pathway by which neighborhood conditions increase the risk for preterm birth is by increasing women's psychological distress. Our objective was to examine whether psychological distress mediated the relationship between neighborhood conditions and preterm birth. Design and Sample One hundred and one pregnant African‐American women receiving prenatal care at a medical center in Chicago participated in this cross‐sectional design study. Measures Women completed the self‐report instruments about their perceived neighborhood conditions and psychological distress between 15–26 weeks gestation. Objective measures of the neighborhood were derived using geographic information systems (GIS). Birth data were collected from medical records. Results Perceived adverse neighborhood conditions were related to psychological distress: perceived physical disorder (r = .26, p = .01), perceived social disorder (r = .21, p = .03), and perceived crime (r = .30, p = .01). Objective neighborhood conditions were not related to psychological distress. Psychological distress mediated the effects of perceived neighborhood conditions on preterm birth. Conclusions Psychological distress in the second trimester mediated the effects of perceived, but not objective, neighborhood conditions on preterm birth. If these results are replicable in studies with larger sample sizes, intervention strategies could be implemented at the individual level to reduce psychological distress and improve women's ability to cope with adverse neighborhood conditions.