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Obesity (Silver Spring). 2019 Jan;27(1):166-173. doi: 10.1002/oby.22356. Epub 2018 Dec 4.

Neighborhood Typology and Cardiometabolic Pregnancy Outcomes in the Maternal Adiposity Metabolism and Stress Study.

Author information

1
Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA.
2
Community Health Sciences, Berkeley School of Public Health, University of California, Berkeley, California, USA.
3
Department of Obstetrics and Gynecology, San Francisco School of Medicine, University of California, San Francisco, California, USA.
4
Institute of Noetic Sciences, Petaluma, California, USA.
5
Department of Psychiatry, San Francisco School of Medicine, University of California, San Francisco, California, USA.

Abstract

OBJECTIVE:

This study aimed to assess associations between neighborhood typologies classified across multiple neighborhood domains and cardiometabolic pregnancy outcomes and determine variation in effectiveness of a mindfulness-based stress-reduction intervention on outcomes across neighborhood types.

METHODS:

Neighborhoods of participants in the Maternal Adiposity Metabolism and Stress (MAMAS) intervention (n = 208) were classified across dimensions of socioeconomic, food, safety, and service/resource environments using latent class analysis. The study estimated associations between neighborhood type and three cardiometabolic pregnancy outcomes-glucose tolerance (GT) during pregnancy, excessive gestational weight gain, and 6-month postpartum weight retention (PPWR)-using marginal regression models. Interaction between neighborhood type and intervention was assessed.

RESULTS:

Five neighborhood types differing across socioeconomic, food, and resource environments were identified. Compared with poor, well-resourced neighborhoods, middle-income neighborhoods with low resources had higher risk of impaired GT (relative risk [RR]: 4.1; 95% confidence Interval [CI]: 1.1, 15.5), and wealthy, well-resourced neighborhoods had higher PPWR (beta: 3.9 kg; 95% CI: 0.3, 7.5). Intervention effectiveness varied across neighborhood type with wealthy, well-resourced and poor, moderately resourced neighborhoods showing improvements in GT scores. PPWR was higher in intervention compared with control groups within wealthy, well-resourced neighborhoods.

CONCLUSIONS:

Consideration of multidimensional neighborhood typologies revealed important nuances in intervention effectiveness on cardiometabolic pregnancy outcomes.

PMID:
30516025
PMCID:
PMC6309242
[Available on 2019-06-04]
DOI:
10.1002/oby.22356

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