Theoretical Insights into Preconception Social Conditions and Perinatal Health: The Role of Place and Social Relationships

Abstract

Recent efforts to explain the stark social and racial disparities in adverse birth outcomes that have persisted for decades in the U.S. have looked beyond prenatal factors, to explore preconception social conditions that may influence perinatal health via dysregulation of physiologic processes. The extant evidence supporting this link however remains limited, both due to a lack of data and theory. To address the latter, this manuscript generates a structured set of theoretical insights that further develop the link between two preconception social conditions — place and social relationships — and perinatal health. The insights propose the following. Place: necessarily encompasses all social contexts to which females are exposed from infancy through young adulthood; encompasses a variety of related exposures that, when possible, should be jointly considered; and may compound the effect of poverty—in childhood, adolescence, or young adulthood—on perinatal health. Social relationships: span relationships from early life through adulthood, and extend to intergenerational associations; often involve (or induce) major changes in the lives of individuals and should be examined with an emphasis on the developmental stage in which the change occurred; and necessarily encompass a lack of social integration, or, social isolation. We also identify potential biological and social-structural mechanisms linking these preconception social conditions to perinatal health, and conclude by identifying promising directions for future research.

Neighborhood-Level Mass Incarceration and Future Preterm Birth Risk among African American Women

“…However, few studies have examined the contextual effect of neighborhood mass incarceration on individual risk of PTB. Furthermore, while there is a rapidly growing body of research on the importance of the preconception period for risk of adverse birth outcomes [16,17], none thus far has examined the potential role of neighborhood incarceration rates in the period preceding a woman's pregnancy on risk of PTB.…”

Points of Interest (POI): a commentary on the state of the art, challenges, and prospects for the future

“…For example, communities with parks facilitate Easter egg hunts or block parties which strengthen familial and neighborhood relationships. The interdependency between place and social relationship can lead to geographic inequity of both physical and mental health outcomes (Kane & Margerison-Zilko, 2017). A place or facility to host festivities can bring good will to a community and offer opportunities to build new networks or revitalize existing ones via social capital (Mair & Duffy, 2020).…”

Measuring the invisible: perinatal health outcomes of unregistered women giving birth in Belgium, a population-based study

“…Access to good-quality housing is often prohibitive, and employment opportunities are limited to the black market, where working conditions are poor and wages are low. Environmental exposure to risk factors in the living and working environment, together with the psychosocial stress caused by poverty, instability, isolation and by the anxiety and discrimination [12,25] that results from leading "invisible" lives, can all adversely affect the mental and physical health of mothers and their unborn babies [24,[26][27][28].…”