Peer-reviewed article
Dutch nationwide registry study to identify spatial, contextual and environmental inequalities in birth outcomes.
Suleri AJ, Bertens LCM, Ahmed I, Pfaff M, van der Hoeven F et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This Dutch study analysed over 1.1 million births from 2015 to 2021 to examine whether babies born in high-risk neighbourhoods (identified by low livability and safety) had worse outcomes than those born elsewhere. Babies born in these neighbourhoods were more likely to be small for their gestational age, born prematurely, or to die in the perinatal period. The researchers found these disparities were consistent across different analyses and neighbourhoods, suggesting that neighbourhood conditions affect newborn health.
Key points
- Small for gestational age was 19% more common in high-risk neighbourhoods (OR 1.19)
- Preterm birth was 9% more common in high-risk neighbourhoods (OR 1.09)
- Perinatal mortality was 13% higher in high-risk neighbourhoods (OR 1.13)
- Disparities persisted across multiple comparisons: high-risk areas versus the rest of the country, each high-risk area versus national levels, and each area versus its municipality
- The study involved 1,118,022 mother-child pairs over 7 years using national registry data
Limitations
The study is observational and identifies associations between neighbourhood characteristics and birth outcomes, but cannot determine causation or whether the relationships are due to neighbourhood environment itself or to unmeasured differences in populations living in those areas. The analysis adjusted for some confounders but residual confounding may remain.
Abstract
Introduction The first 1000 days of life, from conception to age 2, are crucial for a child's development, with lasting health impacts. Evidence is growing that environmental and social factors, especially the neighbourhood of birth, play a significant role in shaping health during this period. This study investigates perinatal health disparities in 20 high-risk Dutch neighbourhoods identified by the governmental National Program on Livability and Safety and outlines an initiative to develop tools aimed at reducing geographical health inequalities and improving birth outcomes. Methods Using data from the national perinatal registry (Perined) from 2015 to 2021, we analysed perinatal outcomes in 1 118 022 mother-child pairs, including perinatal mortality (24 weeks gestation to 7 days postbirth), small for gestational age (SGA; birthweight <10th percentile, corrected for gestational age and sex) and preterm birth (<37 weeks). Three-step logistic regression compared outcomes across all high-risk areas versus the rest of the country, each high-risk area versus national levels and each area versus its municipality, adjusting for confounders and multiple testing. Results We observed that SGA (OR 1.19 (95% CI 1.16 to 1.21)), preterm birth (OR 1.09 (95% CI 1.06 to 1.12)) and perinatal mortality (OR 1.13 (95% CI 1.02 to 1.24)) were significantly higher within high-risk areas compared with the rest of the Netherlands. These disparities persisted across the various comparisons. Conclusion Living in high-risk neighbourhoods, as defined by livability and safety parameters, is linked to adverse birth outcomes, underscoring the need for targeted, location-based policies. Our collaborative initiative aims to co-develop a knowledge agenda with key stakeholders to create actionable tools that reduce health inequalities from birth.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Not an intervention study; rather an observational analysis to document disparities and develop a knowledge agenda with stakeholders for future location-based policies
- Population
- 1,118,022 mother-child pairs born in the Netherlands, 2015-2021, comparing births in 20 high-risk neighbourhoods with births in the rest of the country
Key finding
Small for gestational age: OR 1.19 (95% CI 1.16 to 1.21) in high-risk areas