341 - The Neighborhood Child Opportunity Index and Early Maternal Depressive Symptoms

Poster Number: 341
Publication Number: 341.447

Carol Duh-Leong, NYU Grossman School of Medicine, New York, NY, United States; Yuxiao Lei, New York University Grossman School of Medicine, Bellmore, NY, United States; Eliana M. Perrin, Johns Hopkins University School of Medicine, Baltimore, MD, United States; William Heerman, Vanderbilt University Medical Center, Nashville, TN, United States; Kori Flower, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States; Jonathan S. Schildcrout, Vanderbilt University Medical Center, Nashville, TN, United States; Shelby Wallace, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, United States; Rachel S. Gross, New York University Grossman School of Medicine, New York, NY, United States; Alan L. Mendelsohn, New York University Grossman School of Medicine, New York, NY, United States; David C. Lee, NYU School of Medicine, New York, NY, United States; Lee M. Sanders, Stanford University, Stanford, CA, United States; Russell Rothman, Vanderbilt University Medical Center, Nashville, TN, United States; Alan M. Delamater, University of Miami Leonard M. Miller School of Medicine, Miami, FL, United States; Charles T. Wood, Duke University, Durham, NC, United States; H. Shonna Yin, NYU Grossman School of Medicine, New York, NY, United States

Background: Maternal depression during a child’s first year of life is associated with adverse child health and developmental outcomes. While parent and family-level factors associated with early maternal depression risk are well-studied (e.g., parent education, race/ethnicity), less is known about the role of the neighborhood context, which may exacerbate or mitigate parent and family-level stressors.

Objective: Examine associations between the neighborhood child opportunity index surveillance tool and maternal depressive symptoms in the newborn period and at 12 months in a study sample with racial and socioeconomic diversity.

Design/Methods:

Longitudinal analyses of geocoded and parent-reported data from caregivers enrolled in the control arm of the Greenlight Plus obesity prevention RCT across 6 US cities. Inclusion: English/Spanish-speaking mothers with healthy full-term babies. The main exposures were measured using the Neighborhood Child Opportunity Index (ChOI), mapped to mother’s address at infant’s birth. This is a location-based surveillance tool that measures the following domains with higher nationally-normed scores indicative of increased child opportunity in: 1) Education (e.g., preschool, elementary, high school access, educational attainment); 2) Health/Environment (e.g., healthy food access, green space); 3) Economic (e.g., poverty, employment rate). Maternal depressive symptoms were collected in the newborn period (infant age 0-21 days) and 12 months via the Patient Health Questionnaire-9 (PHQ-9). We used an ordinal regression model (given PHQ-9 distribution skew) to examine PHQ-9 score as the outcome in the newborn period and at 12 months controlling for each of the three ChOI domains and for relevant covariates.

Results: N=410: 49% Hispanic; 18% Black. 21% had increased maternal depression risk in the newborn period (PHQ-9 score >5). A 1-standard deviation increase in health/environment ChOI Z-score was associated with lower odds of maternal depression risk in the newborn period (aOR 0.58; 95% CI: 0.37, 0.90), but not at 12 months. We did not detect significant associations between other ChOI domains and PHQ-9 in the newborn period or at 12 months (Table).

Conclusion(s): A more favorable score on the health/environment ChOI domain was significantly associated with decreased odds of maternal depressive symptoms in the newborn period. Future studies should examine how aspects of the health/environment domain may be particularly relevant to maternal depression risk in the newborn period, informing neighborhood-level intervention studies to optimize maternal-child well-being.