Protective Places: the Relationship between Neighborhood Quality and Preterm Births to Black Women in Oakland, California (2007–2011)

Rs, Berkowitz; Mujahid, Mahasin S.; Pearl, Michelle; Poon, Victor; Reid, Carolina; Allen, Amani M.

doi:10.1007/s11524-022-00624-8

Cited by 4 publications

(4 citation statements)

References 85 publications

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“…Prior research has identified communities with lower composite health index scores as those with increased barriers to accessing health care resources and worse health outcomes. 12,14,15 Our study demonstrates that these trends hold true, as women residing in areas with lower composite health index scores were less likely to undergo fertility-sparing treatment or ART. Tools such as the California Healthy Places Index can help target program interventions to the communities with the most need.…”

Section: Discussionmentioning

confidence: 64%

“…Additionally, prior research has found associations between lower composite health of an individual's community (as measured by community health indices), decreased access to health services, and worse health outcomes. [12][13][14][15] Notably, none of these studies have evaluated the association between geospatial and health indices and fertility-sparing treatment and ART among survivors of breast and gynecologic cancers.…”

mentioning

confidence: 99%

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Patient Location and Disparities in Access to Fertility Preservation for Women With Gynecologic or Breast Cancer

Kanbergs,

Jorgensen,

Agusti

et al. 2024

Obstetrics &Amp; Gynecology

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OBJECTIVE: To assess the effect of geographic factors on fertility-sparing treatment or assisted reproductive technology (ART) utilization among women with gynecologic or breast cancers. METHODS: We conducted a cohort study of reproductive-aged patients (18–45 years) with early-stage cervical, endometrial, or ovarian cancer or stage I–III breast cancer diagnosed between January 2000 and December 2015 using linked data from the California Cancer Registry, the California Office of Statewide Health Planning and Development, and the Society for Assisted Reproductive Technology. Generalized linear mixed models were used to evaluate associations between distance from fertility and gynecologic oncology clinics, as well as California Healthy Places Index score (a Census-level composite community health score), and ART or fertility-sparing treatment receipt. RESULTS: We identified 7,612 women with gynecologic cancer and 35,992 women with breast cancer. Among all patients, 257 (0.6%) underwent ART. Among patients with gynecologic cancer, 1,676 (22.0%) underwent fertility-sparing treatment. Stratified by quartiles, residents who lived at increasing distances from gynecologic oncology or fertility clinics had decreased odds of undergoing fertility-sparing treatment (gynecologic oncology clinics: Q2, odds ratio [OR] 0.76, 95% CI, 0.63–0.93, P=.007; Q4, OR 0.72, 95% CI, 0.56–0.94, P=.016) (fertility clinics: Q3, OR 0.79, 95% CI, 0.65–0.97, P=.025; Q4, OR 0.67, 95% CI, 0.52–0.88, P=.004), whereas this relationship was not observed among women who resided within other quartiles (gynecologic oncology clinics: Q3, OR 0.81 95% CI, 0.65–1.01, P=.07; fertility clinics: Q2, OR 0.87 95% CI, 0.73–1.05, P=.15). Individuals who lived in communities with the highest (51st–100th percentile) California Healthy Places Index scores had greater odds of undergoing fertility-sparing treatment (OR 1.29, 95% CI, 1.06–1.57, P=.01; OR 1.66, 95% CI, 1.35–2.04, P=.001, respectively). The relationship between California Healthy Places Index scores and ART was even more pronounced (Q2 OR 1.9, 95% CI, 0.99–3.64, P=.05; Q3 OR 2.86, 95% CI, 1.54–5.33, P<.001; Q4 OR 3.41, 95% CI, 1.83–6.35, P<.001). CONCLUSION: Geographic disparities affect fertility-sparing treatment and ART rates among women with gynecologic or breast cancer. By acknowledging geographic factors, health care systems can ensure equitable access to fertility-preservation services.

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Section: Discussionmentioning

confidence: 64%

mentioning

confidence: 99%

Patient Location and Disparities in Access to Fertility Preservation for Women With Gynecologic or Breast Cancer

Kanbergs,

Jorgensen,

Agusti

et al. 2024

Obstetrics &Amp; Gynecology

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“…8,9,11 There is increasing appreciation of how neighborhood conditions and community factors influence PTB. [12][13][14][15][16][17] Poverty, 18 air pollution, 19,20 and composite measures of neighborhood quality 21 are associated with PTB. Communities reflect a complex amalgamation of risk and protective factors.…”

Section: Introductionmentioning

confidence: 99%

County-Level Maternal Vulnerability and Preterm Birth in the US

et al. 2023

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ImportanceAppreciation for the effects of neighborhood conditions and community factors on perinatal health is increasing. However, community-level indices specific to maternal health and associations with preterm birth (PTB) have not been assessed.ObjectiveTo examine the association of the Maternal Vulnerability Index (MVI), a novel county-level index designed to quantify maternal vulnerability to adverse health outcomes, with PTB.Design, Setting, and ParticipantsThis retrospective cohort study used US Vital Statistics data from January 1 to December 31, 2018. Participants included 3 659 099 singleton births at 22 plus 0/7 to 44 plus 6/7 weeks of gestation born in the US. Analyses were conducted from December 1, 2021, through March 31, 2023.ExposureThe MVI, a composite measure of 43 area-level indicators, categorized into 6 themes reflecting physical, social, and health care landscapes. Overall MVI and theme were stratified by quintile (very low to very high) by maternal county of residence.Main Outcomes and MeasuresThe primary outcome was PTB (gestational age &lt;37 weeks). Secondary outcomes were PTB categories: extreme (gestational age ≤28 weeks), very (gestational age 29-31 weeks), moderate (gestational age 32-33 weeks), and late (gestational age 34-36 weeks). Multivariable logistic regression quantified associations of MVI, overall and by theme, with PTB, overall and by PTB category.ResultsAmong 3 659 099 births, 298 847 (8.2%) were preterm (male, 51.1%; female, 48.9%). Maternal race and ethnicity included 0.8% American Indian or Alaska Native, 6.8% Asian or Pacific Islander, 23.6% Hispanic, 14.5% non-Hispanic Black, 52.1% non-Hispanic White, and 2.2% with more than 1 race. Compared with full-term births, MVI was higher for PTBs across all themes. Very high MVI was associated with increased PTB in unadjusted (odds ratio [OR], 1.50 [95% CI, 1.45-1.56]) and adjusted (OR, 1.07 [95% CI, 1.01-1.13]) analyses. In adjusted analyses of PTB categories, MVI had the largest association with extreme PTB (adjusted OR, 1.18 [95% CI, 1.07-1.29]). Higher MVI in the themes of physical health, mental health and substance abuse, and general health care remained associated with PTB overall in adjusted models. While the physical health and socioeconomic determinant themes were associated with extreme PTB, physical health, mental health and substance abuse, and general health care themes were associated with late PTB.Conclusions and RelevanceThe findings of this cohort study suggest that MVI was associated with PTB even after adjustment for individual-level confounders. The MVI is a useful measure for county-level PTB risk that may have policy implications for counties working to lower preterm rates and improve perinatal outcomes.

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“…La estimación adecuada de la edad gestacional (EG) es fundamental para evitar decisiones obstétricas y perinatales erróneas (1). Los cálculos de la EG por la fecha de última menstruación (FUM) pueden estar sesgados, ya que el momento de ovulación varía desde el punto de vista fisiológico (2). Además, la capacidad de recuerdo de las mujeres también modifica la fiabilidad del cálculo (3).…”

Section: Introductionunclassified

Usefulness of fetal sacral length measurement for the prediction of gestational age

Reyna-Villasmil,

Mejía-Montilla,

Torres-Cepeda

et al. 2023

RSOGV

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Objective: To establish the usefulness of fetal sacral length measurement for the prediction of gestational age. Methods: A longitudinal and prospective study was conducted between January 2016 and December 2022 in women with low-risk singleton pregnancies, between 14 and 40 weeks of gestation, who attended prenatal consultation at the Central Hospital “Dr. Urquinaona”, Maracaibo. Biparietal diameter, abdominal circumference, femur length, and fetal sacrum length were measured during pregnancy. Results: For the final analysis, data from 215 healthy women was selected. A total of 3,033 total evaluations were performed, with the lowest number of evaluations at 38 weeks with 104 and the highest number of 139 at 22 weeks. When analyzing the correlation between sacral length and gestational age by date of last menstrual period and the rest of the ultrasound variables used, strong, positive, and significant correlations were found (p < 0.0001). The average difference between the gestational age determined by the date of the last menstrual period and that obtained by the model was +/- 0.3 weeks. The value of the coefficient of determination of the model of gestational age predicted by measurement was 0.975. When combining the four ultrasound parameters studied in the resulting model, it was 0.990. Conclusion: Measurement of fetal sacral length by ultrasonography is useful for predicting gestational age with high precision.

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Protective Places: the Relationship between Neighborhood Quality and Preterm Births to Black Women in Oakland, California (2007–2011)

Cited by 4 publications

References 85 publications

Patient Location and Disparities in Access to Fertility Preservation for Women With Gynecologic or Breast Cancer

Patient Location and Disparities in Access to Fertility Preservation for Women With Gynecologic or Breast Cancer

County-Level Maternal Vulnerability and Preterm Birth in the US

Usefulness of fetal sacral length measurement for the prediction of gestational age

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