Completing our trilogy of papers on neighborhood built environments and pregnancy and birth outcomes, we published a paper in the June issue of JAMA Network Open showing links between neighborhood food environments and birth weight in NYC. Babies born either small- or large-for-gestational age, a measure of birth weight adjusted for length of pregnancy, are at greater risk for long term health complications, but until now little was known about how neighborhood characteristics including walkability and the food environment, may affect birthweight outcomes.

In collaboration with the Bureau of Vital Statistics at the New York City Department of Health and Mental Hygiene we analyzed the records of 106,194 singleton births in NYC in 2015. The prevalence of babies baby born small for gestational age was 13 percent and the percent born large for gestational age was 8.4 percent.  Residing in the most dense healthy retail food environment compared to the lowest was associated with a 11% lower risk of delivering a baby whose weight was low for gestational age.   Conversely, compared to residing in a neighborhood with the lowest density of unhealthy retail food outlets, residing in a neighborhood with the highest density of unhealthy food outlets was associated with a 16 to 18% increase in the risk of a baby being born large for gestational age.

The locations of retail food establishments were identified using the 2014 National Establishment Time Series data set, which provides a census of businesses and institutions in the US. Retail food establishments were a priori grouped into healthy and unhealthy categories based on whether the types of food sold support a healthy weight. For instance, full-service supermarkets and fruit and vegetable markets were classified as healthy, and fast-food outlets, convenience stores, and candy stores as were classified as unhealthy.

The prequel papers in this series reported our findings that higher neighborhood walkability was protective against excess gestational weight gain and against gestational diabetes. The lead author for this paper is Eliza Kinsey who was previosuly a post-doctoral fellow at the Mailman School and is now an Assistant Professor at the Univesity of Pennsylvania.