TY - GEN A1 - Wandschneider, Lisa A1 - Sauzet, Odile A1 - Breckenkamp, Jürgen A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Small-Area Factors and Their Impact on Low Birth Weight—Results of a Birth Cohort Study in Bielefeld, Germany T2 - Frontiers in Public Health N2 - Introduction: The location of residence is a factor possibly contributing to social inequalities and emerging evidence indicates that it already affects perinatal development. The underlying pathways remain unknown; theory-based and hypothesis-driven analyses are lacking. To address these challenges, we aim to establish to what extent small-area characteristics contribute to low birth weight (LBW), independently of individual characteristics. First, we select small-area characteristics based on a conceptual model and measure them. Then, we empirically analyse the impact of these characteristics on LBW. Material and methods: Individual data were provided by the birth cohort study “Health of infants and children in Bielefeld/Germany.” The sample consists of 892 eligible women and their infants distributed over 80 statistical districts in Bielefeld. Small-area data were obtained from local noise maps, emission inventory, Google Street View and civil registries. A linear multilevel analysis with a two-level structure (individuals nested within statistical districts) was conducted. Results: The effects of the selected small-area characteristics on LBW are small to non-existent, no significant effects are detected. The differences in proportion of LBW based on marginal effects are small, ranging from zero to 1.1%. Newborns from less aesthetic and subjectively perceived unsafe neighbourhoods tend to have higher proportions of LBW. Discussion: We could not find evidence for negative effects of small-area factors on LBW, but our study confirms that obtaining adequate sample size, reliable measure of exposure and using available data for operationalisation of the small-area context represent the core challenges in this field of research. KW - low birth weight KW - small-area analysis KW - multilevel analysis KW - virtual audit KW - noise pollution KW - fine particulate matter KW - socioeconomic deprivation KW - cohort study Y1 - 2020 UR - https://opus4.kobv.de/opus4-UBICO/frontdoor/index/index/docId/25636 SN - 2296-2565 VL - 8 ER -