Abstract
BACKGROUND: Prepregnancy cardiometabolic risk factors are associated with increased risks of adverse pregnancy outcomes. Neighbourhood features may reflect prepregnancy exposures that contribute to poor cardiometabolic health before pregnancy and may contribute to racial disparities in pregnancy outcomes. METHODS: Early pregnancy measurements from 1504 women enrolled in the Prenatal Exposures and Preeclampsia Prevention study were linked to a 2000 Census-based measure of neighbourhood socio-economic status and commercial data (food, alcohol, and retail density) during 1997-2001. Multilevel random-intercept linear regression was used to separately estimate the association between levels of neighbourhood assets (low, mid-low, mid-high, high) and C-reactive protein (CRP), systolic blood pressure (SBP), and body mass index (BMI) in cross-sectional analyses. Low neighbourhood assets have high-poverty/low-retail, whereas high neighbourhood assets have low-poverty/high-retail. Models were adjusted for individual-level factors (age and race), and we assessed effect modification by race. RESULTS: Low compared with high neighbourhood assets were associated with higher BMI (β 1.95 kg/m(2) , 95% CI 0.89, 3.00), after adjusting for individual-level covariates. After adjusting for BMI and other covariates, low compared with high assets were associated with higher CRP concentrations (β 0.20 ng/mL, 95% CI 0.01, 0.39). Neighbourhood assets were not associated with SBP. Race did not modify the association between neighbourhood assets and cardiometabolic risk factors. CONCLUSIONS: Early pregnancy adiposity is related to neighbourhood features independent of individual factors. Further, inflammation beyond accounting for adiposity is related to neighbourhood features. Strategies that address neighbourhood assets during preconception and interconception may be promising approaches to improve prepregnancy health.