Prenatal homelessness, food insecurity, and unemployment and adverse infant outcomes in a California cohort, 2007-2020.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY Journal of Perinatology Pub Date : 2024-11-15 DOI:10.1038/s41372-024-02161-5

Lucia Ferrer, Christina Chambers, Anup Katheria, Annie Nguyen, Gretchen Bandoli

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Abstract

Objectives: Characterize the relationship between infant outcomes and prenatal homelessness, food insecurity and unemployment.

Study design: California live births between 22- and 44-weeks' gestation comprised 6,089,327 pregnancies (2007-2020). Data were collected from linked Vital Statistics and hospital discharge records. Prenatal homelessness, food insecurity, and unemployment were classified as health-related social needs (HRSN) using International Classification of Disease codes in delivery records. Risk ratios for preterm birth, low birthweight, small for gestational age, neonatal intensive care unit admission, emergency department admission, rehospitalization, and death were estimated using log-linear Poisson regression adjusted for birthing person race, payer, and education.

Results: 65.7 per 100,000 births had HRSN. These infants had a higher risk of preterm birth (aRR 2.7), low birthweight (aRR 2.7), SGA (aRR 1.5), NICU admission (aRR 3.5), and death (aRR 3.0).

Conclusions: HRSN increase the risk of infant morbidity and mortality but remain underreported in administrative records, making definitive conclusions difficult.

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2007-2020 年加州队列中的产前无家可归、粮食不安全和失业与婴儿不良结局。

研究目的研究设计：研究设计：加利福尼亚州妊娠 22 周至 44 周的活产婴儿包括 6,089,327 名孕妇（2007-2020 年）。数据收集自相关的生命统计和医院出院记录。根据分娩记录中的国际疾病分类代码，产前无家可归、粮食不安全和失业被归类为与健康相关的社会需求（HRSN）。采用对数线性泊松回归法估算了早产、低出生体重、胎龄小、新生儿重症监护室入院、急诊科入院、再次入院和死亡的风险比，并对分娩者的种族、付款人和教育程度进行了调整：每 10 万名新生儿中有 65.7 名患有 HRSN。这些婴儿早产（aRR 2.7）、低出生体重（aRR 2.7）、SGA（aRR 1.5）、入住新生儿重症监护室（aRR 3.5）和死亡（aRR 3.0）的风险较高：结论：HRSN 增加了婴儿发病和死亡的风险，但行政记录中的报告仍然不足，因此很难得出明确的结论。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.