Date of Conferral

2019

Degree

Ph.D.

School

Public Health

Advisor

Shingairai Feresu

Abstract

Infant mortality (IM) rates in the United States remains high. The higher rates of IM among specific groups in the United States is believed to be fueled by the high rates of adverse birth outcomes including low birthweight (LBW) and preterm births (PTB) among these groups. Adverse birth outcomes have also been linked to the presence of hypertensive disorders during pregnancy. The purpose of this cross-sectional study was to explore the association between hypertensive disorders during pregnancy and adverse birth outcomes and the impact of the residential neighborhood of expectant mothers on this association. The life course health development theory guided the framework for this study. Study data were obtained from the 2010 New York City birth records and the 2010 US Census. Descriptive statistics and logistic regression analysis were used to address the 3 research hypotheses of the study. The study found that prepregnancy hypertension (HTN) (AOR: 2.84 & 3.25), gestational HTN (AOR: 2.28 & 3.33) and eclampsia (AOR: 4.41 & 6.70) were significantly associated with PTB and LBW respectively. Neighborhood segregation was not significant for PTB (AOR: 1.01) or LBW (AOR: 1.03). Neighborhood poverty was significant for PTB (AOR: 0.86) but not for LBW (AOR: 1.05). Neighborhood segregation and poverty had significant moderating effects on the prepregnancy HTN (p = 0.00), gestational HTN (p = 0.00), eclampsia (p = 0.00) and PTB and LBW association. Results from this study can help to address disparities in birth outcomes among women of differing races and ethnicities and thereby contribute to positive social change.

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