One of the major challenges in researching neighborhoods and birth outcomes today concerns access to neighborhood‐level data. The present study combines local data from the Pittsburgh Neighborhood and Community Information System with data from the national American Community Survey to examine the relationship between adverse birth outcomes (i.e., low birth weight, preterm birth, and infant mortality) and neighborhood distress. We examine racial differences in neighborhood distress using the census‐based measure of socioeconomic disadvantage as well as measures of abandonment from local data sources, including vacancy, violence, tax delinquency, property sales, and property conditions. Results reveal significant differences in neighborhood distress by race for every aspect examined. Furthermore, findings show that abandonment‐related measures explain a substantial portion of variation in adverse birth outcomes, with tax delinquency explaining more variation than socioeconomic disadvantage. We discuss the implications of these findings for future research and for strategies to reduce racial disparities in birth outcomes.