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Research Article: Place-Based Strategies Addressing Neighborhood Environments to Improve Perinatal and Preterm Infant Outcomes

Date Published: 2023-10-02

Abstract:
Preterm birth (defined as birth <37 weeks of gestation) is a significant health concern globally, with lasting implications for individuals, families, and society. In the United States, high preterm birth rates among Black and low-income populations likely result from differences in environmental exposures. Structural racism and economic disadvantage have led to unequal distribution of polluting industrial sites and roadways across society as well as differential access to health-promoting resources which contribute to preterm birth risk. Once born, preterm infants remain at risk for numerous environmentally responsive adverse health outcomes that affect growth and development throughout childhood and adulthood. In this commentary, we describe associations of neighborhood environments with pregnancy and preterm infant health outcomes and propose strategies to address harmful exposures that affect families across the lifespan.

Introduction:
In the United States, the preterm birth rate rose 4% in 2021 to 10.49%, after an overall decline from 2007 to 2020 [1], with persistent significant racial disparities. The preterm birth rate is 50% higher for Black compared to White individuals [1,2,3]. Black infants are also three times more likely to be born <28 weeks’ gestation, which represents the most vulnerable neonatal population for multiple medical morbidities and mortality [4]. Racism, not race, contributes to racial disparities in preterm birth…

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