Exposure to Community Homicide During Pregnancy and Preterm Birth: A Within-Community Matched Design

Dana Goin , University of California, Berkeley
Anu Gomez, University of California, Berkeley
Kriszta Farkas, University of California, Berkeley
Scott Zimmerman, University of California, Berkeley
Ellicott Matthay, Evidence for Action
Jennifer Ahern, University of California, Berkeley

Community violence is an understudied aspect of social context that may influence racial/ethnic disparities in risk of preterm birth. We matched California mothers who were exposed to a homicide in 2007-2011 to unexposed mothers on tract, age, race/ethnicity, educational attainment, and year of conception. We estimated the average treatment effect on the treated (ATT) of homicide exposure during early pregnancy on risk of preterm birth, controlling for season of conception and health insurance. We found increased risk of preterm birth associated with homicide, with larger associations during the first trimester (ATT 0.006 [95% CI 0.004, 0.008]) compared to the second trimester (ATT 0.004 [95% CI 0.002, 0.006]). The ATT was largest for non-Hispanic black women exposed during the first trimester (ATT 0.012 [95% CI 0.002, 0.022]). Results suggest exposure to homicide in early pregnancy increases risk of preterm birth and likely contributes to racial/ethnic disparities in preterm birth.

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 Presented in Session 213. Maternal Morbidity and Mortality in the United States