Abstract
Objectives
Maternal substance use during pregnancy is a known risk factor for poor birth outcomes
and lifelong health consequences. In addition, exposure to domestic and community
violence can be associated with adverse birth outcomes. Due to limited research examining
public health challenges linked to prenatal substance exposure (PSE)/neonatal abstinence
syndrome (NAS) at the population level, we examined possible geographic and temporal
intersections between (1) community violence and PSE/NAS, and (2) community gun violence
and PSE/NAS.
Study Design
We conducted a study using abstracted records of neonates born at a tertiary referral
hospital from 2012 to 2019 having a diagnosis code for PSE/NAS (n = 1,523). Cases of community violence were identified using a hospital-based Trauma
Registry during the 2012 to 2019 period (n = 1,580). We identified zones of spatial clustering and geographic overlap between
community violence and PSE/NAS using emerging hot spot analysis.
Results
Geographic and temporal clustering of PSE/NAS occurred. PSE/NAS had statistically
significant zones of overlap with community assault cases (New Hot Spot 15 zones,
Consecutive 5 zones, Sporadic Hot Spot 62 zones with a p < 0.01). PSE/NAS also clustered with community gun violence (New Hot Spot 11 zones,
Consecutive Hot Spot 90 zones, Intensifying Hot Spot 13 zones, Sporadic Hot Spot 20
zones with a p < 0.01).
Conclusion
Spatiotemporal overlap occurred between community violence and the adverse neonatal
event of PSE/NAS. By allocating resources to identified geographic areas of increased
risk, the health of vulnerable communities can be improved.
Key Points
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PSE/NAS geographically and temporally clusters with community violence.
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PSE/NAS geographically and temporally clusters with community gun violence.
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Resources should be provided to communities with increased risk.
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By allocating resources, communities members' health can be improved.
Keywords
community violence - neonatal abstinence syndrome - prenatal substance exposure
