Preterm birth among pregnant women living in areas with high social vulnerability

• Published in: American journal of obstetrics & gynecology MFM 2021-09, Vol.3 (5), p.100414-100414, Article 100414
• Main Authors: Givens, Matthew, Teal, E. Nicole, Patel, Varun, Manuck, Tracy A.
• Format: Article
• Language: English
• Subjects: preterm birth; social determinants of health; social vulnerability
• ISSN: 2589-9333; 2589-9333
• DOI: 10.1016/j.ajogmf.2021.100414

Communities and individuals widely vary in their resources and ability to respond to external stressors and insults. To identify vulnerable communities, the Centers for Disease Control and Prevention developed the Social Vulnerability Index, an integrated tool to assess community resources and preparedness; it is based on 15 factors and includes individual scores in the following 4 themes: socioeconomic status (theme 1), household composition and disability (theme 2), minority status and language (theme 3), and housing type and transportation (theme 4) and an overall composite score. Several Social Vulnerability Index components have been independently associated with an increased risk of preterm birth. We sought to investigate the association of the Social Vulnerability Index for each patient's residence during pregnancy, personal clinical risk factors, and preterm birth. This was a retrospective cohort study of women carrying nonanomalous singleton or twin gestations delivering at a large university health system from April 2014 to January 2020. Women at high risk of spontaneous and medically indicated preterm birth were assigned to a census tract based on their geocoded home address, and a Social Vulnerability Index score was assigned to each individual by linking each patient's home address at the census tract level. Higher scores indicate greater social vulnerability. The primary outcome was preterm birth at