Maternal depression and adverse neighbourhood conditions during pregnancy are associated with gestational epigenetic age deceleration

Figures & data

Table 1 Domains and indicators of neighbourhood conditions.

Domain	Indicator	Description (source)
Health & environment
	Access to healthy food	Percent households without a car located further than a half-mile from the nearest supermarket, reversed (USDA)
	Access to green space	Percent impenetrable surface areas such as rooftops, roads, or parking lots (CDC)
	Extreme heat exposure	Summer days with maximum temperature above 90°F (CDC)
	Health insurance coverage	Percent individuals ages 0–64 with health insurance coverage (ACS)
	Ozone concentration	Mean estimated 8-hour average ozone concentration (EPA)
	Particulate matter (PM2.5) concentration	Mean estimated PM2.5 concentration (CDC)
	Industrial pollutants in air, water or soil	Index of toxic chemical released by industrial facilities (EPA)
	Hazardous waste dump sites	Average number of Superfund sites within a 2-mile radius (EPA)
	Housing vacancy rate	Percent housing units that are vacant (ACS)
	Walkability	EPA Walkability Index (EPA)
Social & economic
	Poverty rate	Percent individuals living in households with incomes below 100% of the federal poverty threshold (ACS)
	Public Assistance	Percentage receiving cash public assistance or food stamps/Supplemental Nutrition Assistance Program (ACS)
	Homeownership rate	Percent owner-occupied housing units (ACS)
	High-skill employment	Percent individuals ages 16 and over employed in management, business, financial, computer, engineering, science, education, legal, community service, health care practitioner, health technology, arts and media occupations (ACS)
	Median household income	Median income of all households (ACS)
	Employment rate	Percent adults ages 25–54 who are employed (ACS)
	Single-headed households	Percent family households that are single-parent headed (ACS)
	Commute duration	Percent workers commuting more than one hour one way (ACS)
Education
	Adult educational attainment	Percent adults ages 25 and over with a college degree or higher (ACS)
	High school graduation rate	Percent ninth graders graduating from high school on time (EDFacts and GS)
	ECE enrolment	Percent 3- and 4-year-olds enrolled in nursery school, preschool or kindergarten (ACS)
	Early childhood education (ECE) centres	Number of ECE centres within a 5-mile radius (data collection from state and federal sources)
	High-quality ECE centres	Number of NAEYC accredited centres within a 5-mile radius (data collection from state and federal sources)
	School poverty	Percent students in elementary schools eligible for free or reduced-price lunches, reversed (NCES CCD)
	Teacher experience	Percent teachers in their first and second year (CRDC)
	Third grade math proficiency	Percent third graders scoring proficient on standardized math tests, converted to NAEP scale score points (EDFacts, GS and SEDA)
	Third grade reading proficiency	Percent third graders scoring proficient on standardized reading tests, converted to NAEP scale score points (EDFacts, GS and SEDA)
	Advanced Placement (AP) course enrolment	Ratio of students enrolled in at least one AP course to the number of 11^th and 12^th graders (CRDC)
	College enrolment in nearby institutions	Percent 18–24 year-olds enrolled in college within 25-mile radius (ACS)

Abstracted from: Noelke, C., McArdle, N., Baek, M., Huntington, N., Huber, R., Hardy, E., & Acevedo-Garcia, D. (2020). Child Opportunity Index 2.0 Technical Documentation. Retrieved from diversitydatakids.org/research- library/research-brief/how-we-built-it.

Abbreviations: ACS = American Community Survey; CDC = Centers for Disease Control and Prevention; CRDC = Civil Rights Data Collection; EPA = Environmental Protection Agency; EDFacts = U.S. Department of Education EDFacts Data; GS = GreatSchools; NCES CCD = National Center for Health Statistics Common Core of Data; SEDA = Stanford Education Data Archive; USDA = United States Department of Agriculture.

Table 2. Participant characteristics (n = 200).

	Mean (SD)	% (n)
Neighbourhood conditions
Very low opportunity		32.84 (66)
Low opportunity		13.93 (28)
Moderate opportunity		13.43 (27)
High opportunity		19.90 (40)
Very high opportunity		19.90 (40)
Maternal characteristics
Depressive symptoms, sum score	8.70 (5.34)
Age, years	28.66 (5.51)
Race, white/not Hispanic		59.20 (119)
Race, not white and/or Hispanic		40.80 (82)
Education, high school or less		34.33 (69)
Education, more than high school		65.67 (132)
Antidepressant use during pregnancy, yes		8.46 (17)
Antidepressant use during pregnancy, no		91.54 (184)
Smoked during pregnancy, yes		11.44 (23)
Smoking during pregnancy, no		88.56 (178)
Pre-pregnancy BMI	29.02 (8.51)
Pregnancy complications, index	0.71 (0.97)
Western diet, sum score	39.70 (14.57)
Delivery mode, C-section		30.85 (62)
Delivery mode, vaginal		69.15 (139)
Nulliparous, yes		25.37 (51)
Nulliparous, no		74.63 (150)
Infant characteristics
Male		49.75 (100)
Female		50.25 (101)
Gestational age at delivery, weeks	39.00 (1.72)
DNAm gestational age, weeks	39.79 (1.69)

Table 3. Pearson’s correlations among study variables.

	DNAm age	Depressive symptoms	Neighbourhood adversity
DNAm age	1.0
Depressive symptoms	−0.18**	1.0
Neighbourhood adversity	−0.15*	0.11	1.0
Gestational age	0.65***	−0.07	−0.02
Maternal age	−0.0003	−0.0001	−0.16*
White, not Hispanic	−0.03	0.05	−0.26***
Low education	−0.12	0.01	0.25***
Antidepressant use	−0.06	0.33***	−0.11
Smoker	−0.10	0.15*	−0.06
Pre-pregnancy BMI	−0.02	0.11	0.06
Pregnancy complications	−0.24***	0.15*	0.05
Western diet	−0.11	0.10	0.19**
Delivery mode, vaginal	0.06	−0.08	−0.04
Nulliparous	−0.23**	0.08	−0.003
Infant sex, male	0.06	−0.08	−0.08

*p < 0.05, **p < 0.01, ***p < 0.001.

Correlations with DNAm age are adjusted for cell type proportions.

Table 4. Associations between maternal depression and adverse neighbourhood conditions during pregnancy with gestational epigenetic age deceleration.

	Model 1	Model 2	Model 3	Model 4
	β (SE)
Depressive symptoms	−0.03 (0.01) 0.008		−0.03 (0.01) 0.02	−0.03 (0.02) 0.15
Adverse neighbourhood conditions		−0.32 (0.14) 0.02	−0.30 (0.14) 0.03	−0.32 (0.29) 0.26
Depression x Adverse neighbourhood conditions				0.003 (0.03) 0.92

All models were adjusted for cell type proportions (Bcell, CD4T, CD8T, Gran, Mono, NK, nRBC), maternal age, race/ethnicity, education, delivery mode, parity, smoking, antidepressant use, pre-pregnancy body mass index, pregnancy complications, diet, infant sex, and gestational age at birth.

Top cell entry is β (SE); bottom cell entry is the p-value

Table 5. Associations between specific neighbourhood conditions during pregnancy and gestational epigenetic age acceleration.

	β	SE	p
Health and environmental conditions
Healthy food inaccessibility	−0.01	0.004	0.0008
Greenspace inaccessibility	−0.01	0.003	0.05
Extreme heat exposure	−0.05	0.12	0.66
Health insurance coverage	0.04	0.02	0.04
Ozone concentration	0.11	0.13	0.41
PM2.5 concentration	−0.12	0.17	0.48
Industrial pollutants index	−0.01	0.04	0.89
Proximity to Superfund sites	−0.03	0.02	0.19
Housing vacancy rate	0.0001	0.01	0.98
Walkability	−0.03	0.02	0.04
Social and economic conditions
Poverty rate	−0.01	0.005	0.0008
Public assistance rate	−0.01	0.004	0.001
Homeownership rate	0.01	0.002	0.02
High-skill employment	0.01	0.01	0.19
Median household income^+	0.07	0.03	0.01
Employment rate	0.01	0.01	0.30
Single headed household	−0.002	0.003	0.45
Commute duration	0.01	0.02	0.53
Education conditions
Adult educational attainment	0.002	0.005	0.65
High school graduation rate	0.02	0.01	0.02
Early childhood education enrolment	−0.0002	0.003	0.93
Proximity to ECE centres	−0.11	0.06	0.07
Proximity to high quality ECE centres	−0.02	0.01	0.10
School poverty	−0.01	0.004	0.07
Teacher experience	−0.002	0.01	0.88
Third grade math proficiency	0.003	0.001	0.001
Third grade reading proficiency	0.002	0.001	0.006
Advanced placement course enrolment	−0.24	0.33	0.46
College enrolment in nearby institutions	−0.02	0.01	0.03

Separate models were fit for each neighbourhood characteristic.

Associations in bold were statistically significant after Bonferroni adjustment (p = 0.002).

⁺Median household income is expressed in units of $10,000.

All models were adjusted for cell type proportions (Bcell, CD4T, CD8T, Gran, Mono, NK, nRBC), maternal age, race/ethnicity, education, delivery mode, parity, smoking, depressive symptoms, antidepressant use, pre-pregnancy body mass index, pregnancy complications, diet, infant sex, and gestational age at birth.

ECE = Early childhood education.