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Health Equity/Community Health

Poster Session 1

(135) Distressed Community Index and the Association with Preterm Birth

Tuesday, February 13, 2024
10:30 AM – 12:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: To determine whether more socioeconomically distressed communities experience higher rates of preterm birth or earlier gestational age at delivery at a tertiary care hospital in Washington state.

Study Design: We conducted an IRB-approved retrospective cohort study using the Obstetrical Care Outcomes Assessment Program (OBCOAP) at the University of Washington Medical Center. We included the first pregnancy in the dataset for each individual with complete data on gestational age (GA) at delivery and distressed community index (DCI), a tool for measuring the comparative economic well-being of U.S. communities. We evaluated the association between DCI quintile and GA at delivery using linear regression, adjusting for pre-pregnancy substance use, smoking, diabetes, hypertension, and urban/rural class. Chi-square test and Kruskal-Wallis rank test were used for comparison of outcomes across quintiles.

Results: A total of 10,143 individuals were included for analysis, with 39.0% of individuals living in the least distressed communities (DCI quintile =1), and 2.9% in the most distressed communities (DCI quintile = 5). For individuals in the least distressed quintile, gestational age at delivery was 2.5 weeks (95% CI: 2.06, 2.93) later than for individuals in the most distressed quintile, after adjustment for confounders. Individuals in the most distressed communities experienced significantly higher rates of extremely preterm, very preterm, moderate preterm, and late preterm birth compared to the least distressed communities (Table 1).

Conclusion: Our findings indicate that the DCI has the potential to identify patient populations at risk for preterm birth independent of classic risk factors such as smoking, diabetes, substance use, and hypertension. Promising DCI applications could include the creation of neighborhood-specific interventions for addressing the rising rates of preterm deliveries in vulnerable communities.