Evidence map›Paper›PMID 42286123›Full record

ReviewPediatric research2026

Environmental roots of neonatal health: how social and structural exposures shape early-life outcomes.

Khawar Nawaz, Kikelomo Babata, Lisa Scheid, Lynn Bitar, Natalie Vega Ortiz, Srinivas Kota, Lina F Chalak

Abstract readReview
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In one paragraph

Review in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Khawar NawazDivision of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, TX, USA.
Kikelomo BabataDivision of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, TX, USA.
Lisa ScheidDivision of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, TX, USA.
Lynn BitarDivision of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, TX, USA.
Natalie Vega OrtizDivision of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, TX, USA.
Srinivas KotaDivision of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, TX, USA.
Lina F ChalakDivision of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, TX, USA. Lina.Chalak@UTSouthwestern.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Neonatal health in the United States is influenced by a combination of biological, social, environmental, nutritional, and healthcare factors, with structural exposures-such as historical redlining, air pollution, and neighborhood disadvantages-associated with differences in perinatal outcomes. This review synthesizes nearly a century of multidisciplinary evidence linking adverse exposures in utero to persistent disparities in neonatal survival and neurodevelopment. We outline biological mechanisms, notably stress-mediated alterations of the fetal HPA axis and epigenetic changes, that may mediate the effects of social and environmental adversity before birth. Historical and contemporary data highlight the enduring impact of discriminatory policies on neonatal outcomes, emphasizing how structural racism and environmental injustice have been linked to higher rates of preterm birth and low birth weight. In addition, disparities in prenatal care access, food insecurity, infection, and inflammatory conditions represent important pathways through which social conditions may affect fetal growth and neonatal outcomes. Advances in exposomics and biomarker science now allow more precise measurement of early-life exposures, while place-based policy interventions, including urban greening and zoning reform, show promise in mitigating harm. Integrating these scientific and policy approaches is essential to disrupt intergenerational cycles of risk and advance perinatal equity. Bridging socioeconomics, environmental, and biological research offers a path forward to ensuring that all infants- regardless of background- have the opportunity for a healthy start. IMPACT: Review linking social and structural exposures, especially in redlining, air pollution, and environmental injustice disparities in neonatal survival and neurodevelopment. Highlights novel advances in exposomics and place-based policy interventions that target root causes and offer promising strategies to improve perinatal equity. Provides an integrated biological, clinical, and policy framework for disrupting intergenerational cycles of risk and advancing neonatal health equity.

Identifiers

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.