Statement of Purpose Proactive policing is widely implemented in urban contexts as way to deter violence by stopping, searching and surveilling communities, but increasingly research suggests that frequent police contact can have negative health consequences. This study measures neighborhood exposure to proactive policing during pregnancy and its association with preterm birth.

Methods/Approach We analyzed geocoded birth records for all residents of Orleans Parish from 2018–2019 (n=9,131) and defined preterm birth as <37 weeks gestation. We used 2018–2019 field interview data from the New Orleans Police Department and operationalized proactive stops as those due to a ‘suspicious person’, ‘suspicious vehicle’, or ‘present at a crime scene’. Each birth record was linked spatially to the annual average rate of proactive stops within census-tract of residence. We fit multilevel Poisson models with tract-level random intercepts to estimate prevalence ratios for preterm birth across quintiles of stop rates, controlling for age, education, Medicaid status, year, and tract-level unemployment, education, poverty, and population density. We tested for heterogeneity by race/ethnicity.

Results Black pregnant people (59.6% of births) were exposed to an average of 0.04 proactive stops per 1000 population and 15.7% of these births were preterm, compared to 0.02 stops per 1000 and an 8.3% preterm birth prevalence among white pregnant people (28.9% of births). Models indicated a monotonic increased risk of preterm birth associated with each quintile increase in proactive policing. The adjusted prevalence ratio comparing risks in tracts with the highest versus lowest quintile of proactive stops was 1.64 (95% CI 1.09, 2.47). Associations did not vary by race/ethnicity.

Conclusions Frequent proactive police stops are associated with increased risk of preterm birth and this exposure is unequally distributed across race/ethnicity.

Significance Policies that promote proactive policing as a means of deterring violence have negative consequences for other community health outcomes, including preterm birth.