Housing transitions and low birth weight among low-income women: longitudinal study of the perinatal consequences of changing public housing policy

We assessed the longitudinal association between housing transitions and pregnancy outcomes in a sample of public housing residents. A cohort of 2670 Black women residing in Atlanta, Georgia, housing projects with 1 birth occurring between 1994 and 2007 was created from maternally linked longitudinal birth files and followed for subsequent births. Traditional regression and marginal structural models adjusting for time-varying confounding estimated the risk of preterm low birth weight (LBW) or small for gestational age LBW by maternal housing transition patterns. Women moving from public to private housing as a result of housing project demolition were at elevated risk for preterm LBW (risk ratio = 1.74; 95% confidence interval = 1.00-3.04) compared with women not affected by project demolition. Other non-policy-related housing transition patterns were not associated with pregnancy outcomes. Further longitudinal study of housing transitions among public housing residents is needed to better understand the relationship between housing, neighborhoods, housing policy, and perinatal outcomes.