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


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.

SUBMITTER: Headen I 

PROVIDER: S-EPMC6309242 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Publications

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

Headen Irene I   Laraia Barbara B   Coleman-Phox Kimberly K   Vieten Cassandra C   Adler Nancy N   Epel Elissa E  

Obesity (Silver Spring, Md.) 20181204 1


<h4>Objective</h4>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.<h4>Methods</h4>Neighborhoods of participants in the Maternal Adiposity Metabolism and Stress (MAMAS) intervention (n = 208) were classified across dimensions of socioeconomic, food, safety,  ...[more]

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