Spatial analysis of teen births near the New Bedford Harbor Superfund site

Abstract Few studies have examined teen births at an individual-level to identify sociodemographic and environmental risk factors that may contribute to geographically high-risk areas. Communities around the New Bedford Harbor (NBH) Superfund site in southeast Massachusetts are racially and socioeconomically diverse and face potential environmental burdens. These psychosocial, chemical and physical stressors may be associated with behaviors that increase risk of teen birth. We examined associations between teen births (age < 20 years) from 1993–2009 and maternal residence at time of birth among mothers living in towns adjacent to the NBH Superfund site. We used generalized additive models with a smooth of residential location to predict teen birth risk among 29 472 births, adjusted for maternal race/ethnicity, birth country, and source of payment for prenatal care. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated by location across the study area. Approximately 13% of births were to teen mothers. Residential location was significantly associated with teen birth. However, both the strength of associations and areas of elevated risk were attenuated after adjustment. The highest risk was observed north and northeast of the harbor (OR: 95% CI—3.19: 2.08, 4.88 and 2.93: 1.47, 5.82), which aligns with the prevailing wind direction from the harbor. Our study illustrates the importance of assessing the independent contributions of sociodemographic factors to geographic variation in teen birth risk. After accounting for maternal characteristics, results highlight areas within the study region where high-risk individuals may have also experienced environmental stressors.