Social Determinants of Health Needs and Perinatal Risk in Socially Vulnerable Pregnant Patients

To understand perinatal risks associated with social needs in pregnancy Methods. Multivariable log-binomial regression analyses adjusting for age, parity, and insurance were used to evaluate the relationship between any social need (e.g., housing, transportation, food, and intimate partner violence)...

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Bibliographic Details
Published in:Journal of health care for the poor and underserved 2023-05, Vol.34 (2), p.685-702
Main Authors: Joseph, Naima T, Stanhope, Kaitlyn K, Geary, Franklyn, McIntosh, Michelle, Platner, Marissa H, Wichmann, Hannah K, Kramer, Michael R, Jamieson, Denise J, Boulet, Sheree L
Format: Article
Language:English
Subjects:
Births
Blood transfusions
Cardiovascular disease
Diabetes
Domestic violence
Health insurance
Health needs
Healthy food
Hospitals
Households
Housing
Hypertension
Intervention
Intimate partner violence
Low income groups
Medicaid
Medical screening
Medicare
Morbidity
Mortality
Neighborhoods
Obstetrics
Patients
Perinatal
Population
Postpartum period
Pregnancy
Prenatal care
Questionnaires
Regression analysis
Risk
Social factors
Socioeconomic factors
Statistical data
Stillbirth
Transportation
Womens health
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Summary:To understand perinatal risks associated with social needs in pregnancy Methods. Multivariable log-binomial regression analyses adjusting for age, parity, and insurance were used to evaluate the relationship between any social need (e.g., housing, transportation, food, and intimate partner violence) and adverse perinatal outcomes (stillbirth, prematurity, maternal morbidity) in a cohort of English and Spanish-speaking patients who obtained prenatal care and birthed at our institution during a one-year period. Of 2,435 patients, 1,608 (66%) completed social needs screening at least once during prenatal care. The cohort was predominantly non-Hispanic Black (1,294, 80%) and publicly insured (1,395, 87%). Having one or more social need was associated with three-fold increased risk of stillbirth (aRR 3.35, 95%CI 1.31,8.6) and 14% reduction in postpartum care attendance (aRR 0.86, 95%CI 0.78-0.95) and was highest in individuals reporting transportation needs. Social needs during pregnancy were associated with increased risk of stillbirth.
ISSN:1049-2089
1548-6869
1548-6869
DOI:10.1353/hpu.2023.0058