TABLE 3.
Adjusted Associations Between Maternal Periconceptional Census Tract Socioeconomic Measures and Any Neural Tube Defect (NtD), Stratified by Maternal Race/Ethnicity, National Birth Defects Prevention Study, 1997–2011
| Census Tract Level Measurea | Non-Hispanic White | Non-Hispanic Black | Hispanic | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Controls | Any NTD | Controls | Any NTD | Controls | Any NTD | ||||
| n | n | aOR (95% CI)b | n | n | aOR (95% CI)b | n | n | aOR (95% CI)b | |
| NDI total | |||||||||
| NDI | |||||||||
| Q1 (lowest) | 2064 | 283 | Ref | 101 | 14 | Ref | 143 | 35 | Ref |
| Q2 | 1845 | 309 | 1.2 (1.0, 1.4) | 200 | 39 | 1.6 (0.8, 3.2) | 297 | 77 | 1.0 (0.6, 1.6) |
| Q3 | 1466 | 280 | 1.3 (1.1, 1.6) | 336 | 40 | 1.0 (0.5, 2.0) | 556 | 147 | 1.0 (0.7, 1.6) |
| Q4 (highest) | 560 | 92 | 1.1 (0.9, 1.5) | 434 | 75 | 1.6 (0.8, 3.0) | 1383 | 319 | 0.9 (0.6, 1.3) |
| Missing | 1 | 2 | |||||||
| NDI components: | |||||||||
| Crowding | |||||||||
| Q1 (lowest) | 1974 | 273 | Ref | 199 | 29 | Ref | 153 | 29 | Ref |
| Q2 | 1882 | 293 | 1.1 (0.9, 1.3) | 234 | 40 | 1.2 (0.7, 2.0) | 236 | 62 | 1.3 (0.8, 2.2) |
| Q3 | 1458 | 283 | 1.4 (1.1, 1.6) | 357 | 56 | 1.2 (0.7, 1.9) | 529 | 147 | 1.5 (0.9, 2.3) |
| Q4 (highest) | 621 | 115 | 1.3 (1.0, 1.6) | 282 | 43 | 1.1 (0.7, 1.7) | 1461 | 340 | 1.2 (0.8, 1.8) |
| Missing | 1 | 1 | |||||||
| Female-headed households | |||||||||
| Q1 (lowest) | 2069 | 298 | Ref | 72 | 8 | Ref | 223 | 63 | Ref |
| Q2 | 1744 | 314 | 1.2 (1.0, 1.5) | 142 | 17 | 1.1 (0.5, 2.7) | 451 | 118 | 0.9 (0.7, 1.3) |
| Q3 | 1241 | 223 | 1.2 (1.0, 1.5) | 263 | 34 | 1.2 (0.5, 2.7) | 840 | 186 | 0.8 (0.6, 1.1) |
| Q4 (highest) | 881 | 129 | 1.0 (0.8, 1.2) | 595 | 109 | 1.8 (0.8, 3.8) | 865 | 211 | 0.9 (0.6, 1.2) |
| Missing | 1 | 1 | |||||||
| Males in management | |||||||||
| Q1 (lowest) | 840 | 163 | Ref | 401 | 61 | Ref | 1138 | 273 | Ref |
| Q2 | 1567 | 266 | 0.9 (0.7, 1.1) | 296 | 56 | 1.2 (0.8, 1.7) | 515 | 131 | 1.1 (0.8, 1.4) |
| Q3 | 1727 | 296 | 0.9 (0.7, 1.1) | 225 | 31 | 0.8 (0.5, 1.3) | 397 | 96 | 1.1 (0.8, 1.4) |
| Q4 (highest) | 1801 | 240 | 0.7 (0.6, 0.9) | 150 | 20 | 0.8 (0.5, 1.3) | 329 | 78 | 1.0 (0.7, 1.3) |
| Missing | 1 | ||||||||
| Unemployment | |||||||||
| Q1 (lowest) | 1974 | 302 | Ref | 110 | 16 | Ref | 224 | 48 | Ref |
| Q2 | 1739 | 295 | 1.1 (0.9, 1.3) | 232 | 38 | 1.2 (0.6, 2.2) | 404 | 110 | 1.2 (0.9, 1.8) |
| Q3 | 1385 | 224 | 1.0 (0.9, 1.3) | 277 | 38 | 0.9 (0.5, 1.8) | 662 | 142 | 1.0 (0.7, 1.4) |
| Q4 (highest) | 837 | 144 | 1.1 (0.9, 1.4) | 453 | 76 | 1.2 (0.7, 2.2) | 1089 | 278 | 1.1 (0.8, 1.6) |
| Missing | 1 | ||||||||
| Low education | |||||||||
| Q1 (lowest) | 2003 | 293 | Ref | 126 | 20 | Ref | 157 | 41 | Ref |
| Q2 | 1825 | 277 | 1.0 (0.8, 1.2) | 253 | 46 | 1.3 (0.7, 2.3) | 273 | 63 | 0.9 (0.5, 1.3) |
| Q3 | 1457 | 279 | 1.2 (1.0, 1.5) | 376 | 48 | 0.9 (0.5, 1.6) | 523 | 142 | 1.0 (0.7, 1.5) |
| Q4 (highest) | 650 | 116 | 1.1 (0.9, 1.4) | 318 | 54 | 1.3 (0.7, 2.3) | 1426 | 332 | 0.9 (0.6, 1.2) |
| Poverty | |||||||||
| Q1 (lowest) | 2059 | 293 | Ref | 117 | 17 | Ref | 155 | 39 | Ref |
| Q2 | 1798 | 299 | 1.1 (1.0, 1.4) | 214 | 42 | 1.3 (0.7, 2.5) | 317 | 94 | 1.1 (0.7, 1.8) |
| Q3 | 1414 | 260 | 1.2 (1.0, 1.5) | 329 | 43 | 1.0 (0.5, 1.8) | 616 | 155 | 0.9 (0.6, 1.4) |
| Q4 (highest) | 664 | 113 | 1.1 (0.9, 1.4) | 412 | 66 | 1.2 (0.7, 2.3) | 1291 | 290 | 0.9 (0.6, 1.3) |
| Missing | 1 | ||||||||
| Public assistance | |||||||||
| Q1 (lowest) | 1759 | 281 | Ref | 209 | 38 | Ref | 325 | 77 | Ref |
| Q2 | 1736 | 288 | 1.0 (0.9, 1.2) | 216 | 23 | 0.6 (0.3, 1.0) | 407 | 104 | 1.1 (0.8, 1.5) |
| Q3 | 1574 | 247 | 0.9 (0.8, 1.1) | 256 | 48 | 1.1 (0.7, 1.8) | 555 | 119 | 0.9 (0.7, 1.2) |
| Q4 (highest) | 866 | 148 | 1.0 (0.8, 1.2) | 391 | 59 | 0.9 (0.6, 1.4) | 1092 | 278 | 1.1 (0.8, 1.4) |
| Missing | 1 | 1 | |||||||
| Low income | |||||||||
| Q1 (lowest) | 1919 | 263 | Ref | 147 | 24 | Ref | 225 | 56 | Ref |
| Q2 | 1724 | 286 | 1.2 (1.0, 1.4) | 236 | 39 | 1.0 (0.6, 1.7) | 372 | 113 | 1.2 (0.8, 1.7) |
| Q3 | 1425 | 255 | 1.3 (1.0, 1.5) | 279 | 48 | 1.1 (0.6, 1.8) | 660 | 154 | 0.9 (0.7, 1.3) |
| Q4 (highest) | 867 | 160 | 1.3 (1.0, 1.6) | 410 | 57 | 1.0 (0.6, 1.6) | 1122 | 255 | 0.9 (0.6, 1.3) |
| Missing | 1 | 1 | |||||||
a
Census tract measures were obtained from either the 2000 decennial census, the 2005–2009 5-year American Community Survey estimates, or the 2010–2014 5-year American Community Survey estimates. More information is detailed in the methods.
b
Adjusted for maternal age at delivery and maternal education; census tract was included as a correlation matrix.
aOR indicates adjusted odds ratio; CI, confidence interval; NDI, neighborhood deprivation index; NTD, neural tube defect; OR, odds ratio.