Neighborhood Disadvantage is Associated with High Cytomegalovirus Seroprevalence in Pregnancy.
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BACKGROUND: Cytomegalovirus (CMV) is the most common infectious cause of fetal malformations and childhood hearing loss. CMV is more common among socially disadvantaged groups, and geographically clusters in poor communities. The Area Deprivation Index (ADI) is a neighborhood-level index derived from census data that reflects material disadvantage. METHODS: We performed a geospatial analysis to determine if ADI predicts the local odds of CMV seropositivity. We analyzed a dataset of 3527 women who had been tested for CMV antibodies during pregnancy. We used generalized additive models to analyze the spatial distribution of CMV seropositivity. Adjusted models included individual-level age and race and neighborhood-level ADI. RESULTS: Our dataset included 1955 CMV seropositive women, 1549 who were seronegative, and 23 with recent CMV infection based on low avidity CMV antibodies. High ADI percentiles, representing greater neighborhood poverty, were significantly associated with the nonwhite race (48 vs. 22, p < 0.001) and CMV seropositivity (39 vs. 28, p < 0.001). Our unadjusted spatial models identified clustering of high CMV odds in poor, urban neighborhoods and clustering of low CMV odds in more affluent suburbs (local odds ratio 0.41 to 1.90). Adjustment for both individual race and neighborhood ADI largely eliminated this spatial variability. ADI remained a significant predictor of local CMV seroprevalence even after adjusting for individual race. CONCLUSIONS: Neighborhood-level poverty as measured by the ADI is a race-independent predictor of local CMV seroprevalence among pregnant women.
Generalized additive model
Geographic information system
Published Version (Please cite this version)10.1007/s40615-017-0423-4
Publication InfoHoffman, Kate; Hughes, BL; Jackson, Pearce; Kind, A; Lantos, Paul; Permar, Sallie R; & Swamy, Geeta Krishna (2017). Neighborhood Disadvantage is Associated with High Cytomegalovirus Seroprevalence in Pregnancy. J Racial Ethn Health Disparities. 10.1007/s40615-017-0423-4. Retrieved from https://hdl.handle.net/10161/15427.
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Assistant Research Professor in Environmental Sciences and Policy
Associate Professor of Medicine
I am interested in the spatial epidemiology of infectious diseases. My research utilizes geographic information systems (GIS) and geostatistical analyses to understand the spatial and spatiotemporal distribution of diseases, and their relationship with environmental and demographic factors. I currently have active studies evaluating the spatial distribution of numerous domestic and international infectious diseases, as well as studies of neighborhood health disparities in obstetrical care and bi
Professor of Pediatrics
Dr. Permar's work focuses on the development of vaccines to prevent vertical transmission of neonatal viral pathogens. She has utilized the nonhuman primate model of HIV/AIDS to characterize the virus-specific immune responses and virus evolution in breast milk and develop a maternal vaccine regimen for protection against breast milk transmission of HIV. In addition, Dr. Permar's lab has advanced the understanding of HIV-specific immune responses and virus evolution in vertically-transmitting an
Associate Professor of Obstetrics and Gynecology
Dr. Geeta Swamy, MD, became Vice Chair for Research and Faculty Development in the Department of Obstetrics and Gynecology on March 1, 2018. In this dual role, Dr. Swamy oversees strategic development and administration of the Department’s basic, translational and clinical research programs, as well as implements and oversees programs to support development and mentorship for all faculty at all levels. Dr. Swamy has also been instrumental in developing and leading the School of
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