Neighborhood evictions, household children, and preterm birth among Black birthing people.

BACKGROUND: Neighborhood evictions are a key component of community-level housing instability and disproportionately impact communities of color. Increased neighborhood evictions may be associated with increased preterm birth (PTB). Previous research suggests familial distress as a potential driver of increased PTB among Black birthing parents exposed to high neighborhood eviction rates. In this study, we explore whether the association of neighborhood evictions with PTB differs depending on the presence or absence of children in the household during pregnancy. METHODS: We used information from 400 Black participants in the Newborn Epigenetics Study in Durham, NC. Our primary exposure, neighborhood eviction rate, was defined as the participant's block group eviction rate during the year of last menstrual period. Preterm birth, defined as gestational age < 37 completed weeks at delivery was based on information abstracted from medical records at delivery. Using logistic regression, we estimated the change in odds of preterm birth associated with a 1 SD increase in neighborhood eviction rate. Models were adjusted for educational attainment, relationship status, participant age at delivery, and proportion of block group households below the federal poverty line. To determine whether associations between neighborhood evictions and preterm birth differ depending on household composition, we stratified the study sample by presence of children in the household during pregnancy (0, ≥ 1 children). RESULTS: Among the total sample, we observed an increase in odds of preterm birth for every 1-SD increase in neighborhood eviction rate (OR: 1.21, 95% CI: 0.83, 1.73). Association between neighborhood eviction rate and preterm birth differed by household composition. Increased neighborhood eviction rates were associated with increased odds of PTB among participants with children in the household (OR: 1.89, 95% CI: 1.09, 3.28), but not among participants without children in the household (OR: 0.85, 95% CI: 0.49, 1.39). CONCLUSIONS: We found that higher neighborhood evictions increase odds of preterm birth among Black birthing parents living with children. Our findings support the prioritization of Black families and communities for interventions to prevent evictions and promote housing stability.