Brad S St Martin1, Ariana M Spiegel2, Lillian Sie3,4, Stephanie A Leonard2, Dominika Seidman5, Anna I Girsen2, Gary M Shaw4,6, Yasser Y El-Sayed2. 1. Department of Obstetrics & Gynecology, Stanford University, Stanford, CA, USA. brad.stmartin@aya.yale.edu. 2. Department of Obstetrics & Gynecology, Stanford University, Stanford, CA, USA. 3. California Perinatal Quality Care Collaborative, Stanford, CA, USA. 4. Department of Pediatrics,, Stanford University, Stanford, CA, USA. 5. Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA. 6. March of Dimes Prematurity Center, Stanford, CA, USA.
Abstract
OBJECTIVE: Investigate the association between maternal homelessness at the time of delivery and perinatal outcomes, with a focus on neonatal health outcomes. STUDY DESIGN: Population-based cohort using California's statewide database included 1,520,253 women with linked birth and maternal discharge data, 2008-2012. Multivariable analysis assessed homelessness at time of delivery on perinatal outcomes, preterm delivery, and neonatal intensive care unit admission. RESULT: A total of 672 women (0.05%) were homeless at the time of delivery. Homelessness was associated with premature delivery at multiple gestational age cutoffs (34w0d-36w6d; 32w0d-33w6d; 28w0d-31w6d; <28w0d) (range of aORs:1.62-2.19), and neonatal intensive care unit admission (aOR = 1.66, 95% CI:1.31-2.09). Among term infants, homelessness remained associated with increased odds of neonatal intensive care unit admission (aOR = 1.84, 95% CI:1.34-2.53), low birthweight (aOR = 1.99, 95% CI:1.36-2.90), neonatal abstinence syndrome (aOR = 2.13, 95% CI:1.35-2.53), hypoxic-ischemic encephalopathy (aOR = 14.38, 95% CI:3.90-53.01), and necrotizing enterocolitis (aOR = 14.94, 95% CI:2.68-83.20). CONCLUSION: Homelessness in pregnancy was associated with adverse perinatal outcomes including increased odds of preterm delivery across all gestational ages, and increased risk of neonatal intensive care unit admission and low birth weight independent of preterm delivery.
OBJECTIVE: Investigate the association between maternal homelessness at the time of delivery and perinatal outcomes, with a focus on neonatal health outcomes. STUDY DESIGN: Population-based cohort using California's statewide database included 1,520,253 women with linked birth and maternal discharge data, 2008-2012. Multivariable analysis assessed homelessness at time of delivery on perinatal outcomes, preterm delivery, and neonatal intensive care unit admission. RESULT: A total of 672 women (0.05%) were homeless at the time of delivery. Homelessness was associated with premature delivery at multiple gestational age cutoffs (34w0d-36w6d; 32w0d-33w6d; 28w0d-31w6d; <28w0d) (range of aORs:1.62-2.19), and neonatal intensive care unit admission (aOR = 1.66, 95% CI:1.31-2.09). Among term infants, homelessness remained associated with increased odds of neonatal intensive care unit admission (aOR = 1.84, 95% CI:1.34-2.53), low birthweight (aOR = 1.99, 95% CI:1.36-2.90), neonatal abstinence syndrome (aOR = 2.13, 95% CI:1.35-2.53), hypoxic-ischemic encephalopathy (aOR = 14.38, 95% CI:3.90-53.01), and necrotizing enterocolitis (aOR = 14.94, 95% CI:2.68-83.20). CONCLUSION: Homelessness in pregnancy was associated with adverse perinatal outcomes including increased odds of preterm delivery across all gestational ages, and increased risk of neonatal intensive care unit admission and low birth weight independent of preterm delivery.
Authors: Andreea A Creanga; Cynthia J Berg; Carla Syverson; Kristi Seed; F Carol Bruce; William M Callaghan Journal: Obstet Gynecol Date: 2012-08 Impact factor: 7.661
Authors: Matthew S Pantell; Rebecca J Baer; Jacqueline M Torres; Jennifer N Felder; Anu Manchikanti Gomez; Brittany D Chambers; Jessilyn Dunn; Nisha I Parikh; Tania Pacheco-Werner; Elizabeth E Rogers; Sky K Feuer; Kelli K Ryckman; Nicole L Novak; Karen M Tabb; Jonathan Fuchs; Larry Rand; Laura L Jelliffe-Pawlowski Journal: Am J Obstet Gynecol MFM Date: 2019-10-16