• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of amjphAmerican Journal of Public Health Web SiteAmerican Public Health Association Web SiteSubmissionsSubscriptionsAbout Us
Am J Public Health. 1998 November; 88(11): 1674–1680.
PMCID: PMC1508558

Socioeconomic status, neighborhood social conditions, and neural tube defects.

Abstract

OBJECTIVES: This study evaluated the contributions of lower socioeconomic status (SES) and neighborhood socioeconomic characteristics to neural tube defect etiology. The influence of additional factors, including periconceptional multivitamin use and race/ethnicity, was also explored. METHODS: Data derived from a case-control study of California pregnancies from 1989 to 1991. Mothers of 538 (87.8% of eligible) case infants/fetuses with neural tube defects and mothers of 539 (88.2%) nonmalformed infants were interviewed about their SES. Reported addresses were linked to 1990 US census information to characterize neighborhoods. RESULTS: Twofold elevated risks were observed for several SES indicators. Risks were somewhat confounded by vitamin use, race/ethnicity, age, body mass index, and fever but remained elevated after adjustment. A risk gradient was seen with increasing number of lower SES indicators. Women with 1 to 3 and 4 to 6 lower SES indicators had adjusted odds ratios of 1.6 (1.1-2.2) and 3.2 (1.9-5.4), respectively, compared with women with no lower SES indicators. CONCLUSIONS: Both lower SES and residence in a SES-lower neighborhood increased the risk of an neural tube defect-affected pregnancy, with risks increasing across a gradient of SES indicators.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.9M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • ANDERSON WJ, BAIRD D, THOMSON AM. Epidemiology of stillbirths and infant deaths due to congenital malformation. Lancet. 1958 Jun 21;1(7034):1304–1306. [PubMed]
  • Baird D. Epidemiology of congenital malformations of the central nervous system in (a) Aberdeen and (b) Scotland. J Biosoc Sci. 1974 Apr;6(2):113–137. [PubMed]
  • Bower C, Hobbs M, Carney A, Simpson D. Neural tube defects in Western Australia 1966-81 and a review of Australian data 1942-81. J Epidemiol Community Health. 1984 Sep;38(3):208–213. [PMC free article] [PubMed]
  • Brender JD, Suarez L. Paternal occupation and anencephaly. Am J Epidemiol. 1990 Mar;131(3):517–521. [PubMed]
  • Carter CO, Evans K. Spina bifida and anencephalus in greater London. J Med Genet. 1973 Sep;10(3):209–234. [PMC free article] [PubMed]
  • COFFEY VP, JESSOP WJ. A study of 137 cases of anencephaly. Br J Prev Soc Med. 1957 Oct;11(4):174–180. [PMC free article] [PubMed]
  • EDWARDS JH. Congenital malformations of the central nervous system in Scotland. Br J Prev Soc Med. 1958 Jul;12(3):115–130. [PMC free article] [PubMed]
  • Elwood JH, Elwood JM. Investigation of area differences in the prevalence at birth of anencephalus in Belfast. Int J Epidemiol. 1984 Mar;13(1):45–52. [PubMed]
  • Elwood JH, Nevin NC. Factors associated with anencephalus and spina bifida in Belfast. Br J Prev Soc Med. 1973 May;27(2):73–80. [PMC free article] [PubMed]
  • Emanuel I. Non-tuberous neural-tube defects. Lancet. 1972 Oct 21;2(7782):879–879. [PubMed]
  • Fedrick J. Anencephalus in the Oxford Record Linkage Study area. Dev Med Child Neurol. 1976 Oct;18(5):643–656. [PubMed]
  • Fedrick J. Anencephalus: variation with maternal age, parity, social class and region in England, Scotland and Wales. Ann Hum Genet. 1970 Jul;34(1):31–38. [PubMed]
  • Friel JK, Frecker M, Fraser FC. Nutritional patterns of mothers of children with neural tube defects in Newfoundland. Am J Med Genet. 1995 Jan 16;55(2):195–199. [PubMed]
  • Field B. Neural tube defects in New South Wales, Australia. J Med Genet. 1978 Oct;15(5):329–338. [PMC free article] [PubMed]
  • Hemminki K, Mutanen P, Luoma K, Saloniemi I. Congenital malformations by the parental occupation in Finland. Int Arch Occup Environ Health. 1980;46(2):93–98. [PubMed]
  • Laurence KM, Carter CO, David PA. Major central nervous system malformations in South Wales. II. Pregnancy factors, seasonal variation, and social class effects. Br J Prev Soc Med. 1968 Oct;22(4):212–222. [PMC free article] [PubMed]
  • Naggan L, MacMahon B. Ethnic differences in the prevalence of anencephaly and sina bifida in Boston, Massachusetts. N Engl J Med. 1967 Nov 23;277(21):1119–1123. [PubMed]
  • Naggan L. Anencephaly and spina bifida in Israel. Pediatrics. 1971 Mar;47(3):577–586. [PubMed]
  • Nesbit DE, Ziter FA. Epidemiology of myelomeningocele in Utah. Dev Med Child Neurol. 1979 Dec;21(6):754–757. [PubMed]
  • Nevin NC, Johnston WP, Merrett JD. Influence of social class on the risk of recurrence of anencephalus and spina bifida. Dev Med Child Neurol. 1981 Apr;23(2):155–159. [PubMed]
  • Sever LE, Emanuel I. Intergenerational factors in the etiology of anencephalus and spina bifida. Dev Med Child Neurol. 1981 Apr;23(2):151–154. [PubMed]
  • Lovett AA, Gatrell AC, Bound JP, Harvey PW, Whelan AR. Congenital malformations in the Fylde region of Lancashire, England 1957-1973. Soc Sci Med. 1990;30(1):103–109. [PubMed]
  • Fedrick J, Wilson TS. Malformations of the central nervous system in Glasgow. An examination of the evidence for clustering in space and time. Br J Prev Soc Med. 1971 Nov;25(4):210–215. [PMC free article] [PubMed]
  • Richards ID, Roberts CJ, Lloyd S. Area differences in prevalence of neural tube malformations in South Wales. A study of possible demographic determinants. Br J Prev Soc Med. 1972 May;26(2):89–93. [PMC free article] [PubMed]
  • Horowitz I, McDonald AD. Anencephaly and spina bifida in the Province of Quebec. Can Med Assoc J. 1969 Apr 26;100(16):748–755. [PMC free article] [PubMed]
  • Carstairs V, Morris R. Deprivation and mortality: an alternative to social class? Community Med. 1989 Aug;11(3):210–219. [PubMed]
  • Hakama M, Hakulinen T, Pukkala E, Saxén E, Teppo L. Risk indicators of breast and cervical cancer on ecologic and individual levels. Am J Epidemiol. 1982 Dec;116(6):990–1000. [PubMed]
  • Elbourne D, Pritchard C, Dauncey M. Perinatal outcomes and related factors: social class differences within and between geographical areas. J Epidemiol Community Health. 1986 Dec;40(4):301–308. [PMC free article] [PubMed]
  • Haan M, Kaplan GA, Camacho T. Poverty and health. Prospective evidence from the Alameda County Study. Am J Epidemiol. 1987 Jun;125(6):989–998. [PubMed]
  • Curtis SE. Use of survey data and small area statistics to assess the link between individual morbidity and neighbourhood deprivation. J Epidemiol Community Health. 1990 Mar;44(1):62–68. [PMC free article] [PubMed]
  • Krieger N. Women and social class: a methodological study comparing individual, household, and census measures as predictors of black/white differences in reproductive history. J Epidemiol Community Health. 1991 Mar;45(1):35–42. [PMC free article] [PubMed]
  • Morgan M, Chinn S. ACORN group, social class, and child health. J Epidemiol Community Health. 1983 Sep;37(3):196–203. [PMC free article] [PubMed]
  • Krieger N, Rowley DL, Herman AA, Avery B, Phillips MT. Racism, sexism, and social class: implications for studies of health, disease, and well-being. Am J Prev Med. 1993 Nov-Dec;9(6 Suppl):82–122. [PubMed]
  • Shaw GM, Schaffer D, Velie EM, Morland K, Harris JA. Periconceptional vitamin use, dietary folate, and the occurrence of neural tube defects. Epidemiology. 1995 May;6(3):219–226. [PubMed]
  • Croen LA, Shaw GM, Jensvold NG, Harris JA. Birth defects monitoring in California: a resource for epidemiological research. Paediatr Perinat Epidemiol. 1991 Oct;5(4):423–427. [PubMed]
  • Block G, Hartman AM, Dresser CM, Carroll MD, Gannon J, Gardner L. A data-based approach to diet questionnaire design and testing. Am J Epidemiol. 1986 Sep;124(3):453–469. [PubMed]
  • Feldman JG, Stein SC, Klein RJ, Kohl S, Casey G. The prevalence of neural tube defects among ethnic groups in Brooklyn, New York. J Chronic Dis. 1982;35(1):53–60. [PubMed]
  • Hemminki K, Mutanen P, Saloniemi I, Luoma K. Congenital malformations and maternal occupation in Finland: multivariate analysis. J Epidemiol Community Health. 1981 Mar;35(1):5–10. [PMC free article] [PubMed]
  • Sever LE. An epidemiologic study of neural tube defects in Los Angeles County II. Etiologic factors in an area with low prevalence at birth. Teratology. 1982 Jun;25(3):323–334. [PubMed]
  • Borman GB, Smith AH, Howard JK. Risk factors in the prevalence of anencephalus and spina bifida in New Zealand. Teratology. 1986 Apr;33(2):221–230. [PubMed]
  • Coard K, Escoffery C, Golding J, Ashley D. Incidence of anencephaly in Jamaica. Teratology. 1990 Feb;41(2):173–176. [PubMed]
  • Czeizel A, Révész C. Major malformations of the central nervous system in Hungary. Br J Prev Soc Med. 1970 Nov;24(4):205–222. [PMC free article] [PubMed]
  • Granroth G, Haapakoski J, Hakama M. Defects of the central nervous system in Finland. II. Birth order, outcome of previous pregnancies and family history. Teratology. 1978 Jun;17(3):213–222. [PubMed]
  • Ramírez R, Nazer J, Hubner ME, Cifuentes L, Ruiz G, Pizarro MT, Parada L. Incidencia de las malformaciones del sistema nervioso central: período 1978-1988. Rev Med Chil. 1990 May;118(5):530–536. [PubMed]
  • Strassburg MA, Greenland S, Portigal LD, Sever LE. A population-based case-control study of anencephalus and spina bifida in a low-risk area. Dev Med Child Neurol. 1983 Oct;25(5):632–641. [PubMed]
  • Emanuel I, Filakti H, Alberman E, Evans SJ. Intergenerational studies of human birthweight from the 1958 birth cohort. 1. Evidence for a multigenerational effect. Br J Obstet Gynaecol. 1992 Jan;99(1):67–74. [PubMed]
  • Hackman E, Emanuel I, van Belle G, Daling J. Maternal birth weight and subsequent pregnancy outcome. JAMA. 1983 Oct 21;250(15):2016–2019. [PubMed]
  • Klebanoff MA, Graubard BI, Kessel SS, Berendes HW. Low birth weight across generations. JAMA. 1984 Nov 2;252(17):2423–2427. [PubMed]
  • Lumey LH. Decreased birthweights in infants after maternal in utero exposure to the Dutch famine of 1944-1945. Paediatr Perinat Epidemiol. 1992 Apr;6(2):240–253. [PubMed]
  • Sanderson M, Emanuel I, Holt VL. The intergenerational relationship between mother's birthweight, infant birthweight and infant mortality in black and white mothers. Paediatr Perinat Epidemiol. 1995 Oct;9(4):391–405. [PubMed]
  • Emanuel I. Maternal health during childhood and later reproductive performance. Ann N Y Acad Sci. 1986;477:27–39. [PubMed]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...