Mediation of Firearm Violence and Preterm Birth by Pregnancy Complications and Health Behaviors: Addressing Structural and Postexposure Confounding.

ABSTRACT: Firearm violence may indirectly affect health among pregnant women living in neighborhoods where it is endemic. We used birth, death, emergency department, and hospitalization data from California from 2007-2011 to estimate the association between living in a neighborhood with high firearm violence and preterm delivery, and assessed whether there was mediation by diagnoses of pregnancy complications and health behaviors during pregnancy. We used an ensemble machine learning algorithm to predict the propensity for neighborhoods to be classified as having a high level of firearm violence. Risk differences for the total effect and stochastic direct and indirect effects were estimated using targeted maximum likelihood. Residence in high-violence neighborhoods was associated with higher prevale

SUBMITTER: Goin DE 

PROVIDER: S-EPMC7523587 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature