Neighborhood factors associated with physical activity and adequacy of weight gain during pregnancy

Healthy diet, physical activity, smoking, and adequate weight gain are all associated with maternal health and fetal growth during pregnancy. Neighborhood characteristics have been associated with poor maternal and child health outcomes, yet conceptualization of potential mechanisms are still needed. Unique information captured by neighborhood inventories, mostly conducted in northern US and Canadian urban areas, has been shown to reveal important aspects of the community environment that are not captured by the demographic quantities in census data. This study used data from the Pregnancy, Nutrition, and Infection (PIN) prospective cohort study to estimate the influences of individual-level and neighborhood-level characteristics on health behaviors and adequacy of weight gain during pregnancy. Women who participated in the PIN study and who resided in Raleigh, North Carolina and its surrounding suburbs were included (n=703). Results from a neighborhood data collection inventory identified three social constructs, physical incivilities, territoriality, and social spaces, which were hypothesized to influence maternal health behaviors. The physical incivility scale was associated with decreased odds (adjusted OR=0.74, 95% CI=0.57, 0.98) in participating in vigorous leisure activity before pregnancy after controlling for several individual con founders, and a crude association for decreased odds of excessive weight gain (OR=0.79, 95% CI=0.64, 0.98). The social spaces scale was associated with decreased odds for inadequate (adjusted OR=0.74, 95% CI=0.56, 0.98) and excessive (adjusted OR=0.69, 95% CI=0.54, 0.98) gestational weight gain. The social spaces scale was also associated with decreased odds of living greater than 3 miles from a supermarket (adjusted OR=0.03, 95% CI=0.00, 0.27). Territoriality was not associated with any pregnancy-related health behavior. None of the neighborhood constructs were associated with smoking or diet quality. Physical incivilities and social spaces neighborhood characteristics may be important to measure to improve our understanding of the potential mechanisms through which neighborhood environments influence health.