Neighborhood Disadvantage is Associated with High Cytomegalovirus Seroprevalence in Pregnancy.

Lantos, Paul M

Hoffman, Kate

Permar, Sallie R

Jackson, Pearce

Hughes, Brenna L

Kind, Amy

Swamy, Geeta

Switzerland

2017-09-01T19:26:18Z

2017-09-01T19:26:18Z

2017-08-24

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.

https://www.ncbi.nlm.nih.gov/pubmed/28840519

10.1007/s40615-017-0423-4

2196-8837

https://hdl.handle.net/10161/15427

eng

Springer Science and Business Media LLC

J Racial Ethn Health Disparities

10.1007/s40615-017-0423-4

Cytomegalovirus

Generalized additive model

Geographic information system

Health disparities

Poverty

Pregnancy

Spatial epidemiology

Neighborhood Disadvantage is Associated with High Cytomegalovirus Seroprevalence in Pregnancy.

Journal article

Hoffman, Kate|0000-0001-8029-7710

Swamy, Geeta|0000-0001-5092-6993

https://www.ncbi.nlm.nih.gov/pubmed/28840519

Clinical Science Departments

Duke

Medicine

Medicine, General Internal Medicine

Pediatrics

Pediatrics, Infectious Diseases

School of Medicine

Published online