{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T16:24:04Z","timestamp":1773937444571,"version":"3.50.1"},"reference-count":83,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2020,3,27]],"date-time":"2020-03-27T00:00:00Z","timestamp":1585267200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["DP2HD080350"],"award-info":[{"award-number":["DP2HD080350"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R00DA042127"],"award-info":[{"award-number":["R00DA042127"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>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\u20132011 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 prevalence of preterm birth (risk difference (RD)\u00a0=\u00a00.46, 95% confidence interval (CI): 0.13, 0.80), infections (RD\u00a0=\u00a01.34, 95% CI: \u22120.17, 2.86), asthma (RD\u00a0=\u00a00.76, 95% CI: 0.03, 1.48), and substance use (RD\u00a0=\u00a00.74, 95% CI: 0.00, 1.47). The largest indirect effects for the association between violence and preterm birth were observed for infection (stochastic indirect effect = 0.04, 95% CI: 0.00, 0.08) and substance use (stochastic indirect effect = 0.04, 95% CI: 0.01, 0.06). Firearm violence was associated with risk of preterm delivery, and this association was partially mediated by infection and substance use.<\/jats:p>","DOI":"10.1093\/aje\/kwaa046","type":"journal-article","created":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T20:10:17Z","timestamp":1584735017000},"page":"820-831","source":"Crossref","is-referenced-by-count":16,"title":["Mediation of Firearm Violence and Preterm Birth by Pregnancy Complications and Health Behaviors: Addressing Structural and Postexposure Confounding"],"prefix":"10.1093","volume":"189","author":[{"given":"Dana E","family":"Goin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kara E","family":"Rudolph","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anu Manchikanti","family":"Gomez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Ahern","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,3,27]]},"reference":[{"issue":"5","key":"2020091610141367700_ref1","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1097\/EDE.0000000000000879","article-title":"Acute changes in community violence and increases in hospital visits and deaths from stress-responsive diseases","volume":"29","author":"Ahern","year":"2018","journal-title":"Epidemiology"},{"issue":"4","key":"2020091610141367700_ref2","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1007\/s11524-009-9345-8","article-title":"Neighborhood violence and its association with mothers\u2019 health: assessing the relative importance of perceived safety and exposure to 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