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Health Equity/Community Health

Poster Session 4

(938) The association of Social Vulnerability Index (SVI) with acuity of presentation to obstetric triage

Wednesday, February 14, 2024
1:00 PM – 2:30 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective:

To assess the association between CDC Social Vulnerability Index (SVI) with acuity of presentation to obstetric triage.

Study Design:

Secondary analysis of a retrospective cohort study of all triage visits occurring from 20 0/7 through 34 6/7 weeks’ gestation on randomly selected dates from 1/1/2019 through 3/31/2019 at 34 hospitals across the US. Individuals enrolled with geocode and CDC SVI data available were eligible for analysis. The primary exposure was the CDC SVI with a higher number indicating greater vulnerability. The primary outcome was high acuity at presentation to triage, defined as preeclampsia with severe features (for those presenting with hypertensive disorders of pregnancy), cervical dilation >3 cm, or chorioamnionitis (for those presenting with threatened preterm labor or preterm premature rupture of membranes), or delivery within 48 hours of presenting to triage. Additional adverse maternal and neonatal outcomes were compared. All outcomes were also analyzed by the four themes within SVI. Baseline characteristics were compared using Cochran-Armitage or Jonckheere-Terpstra trend tests. Logistic and quantile regressions were used with the lowest SVI quartile (Q1) group as referent.

Results:

Among 2,666 individuals eligible for analysis, 554 (20.8%) were in SVI Q1, 672 (25.2%) in Q2, 649 (24.3%) in Q3, and 791 (29.7%) in Q4. Individuals with higher overall SVI scores were younger, had higher BMI, and were more likely to be multiparous, use tobacco, drugs, and live with co-morbidities. SVI quartiles were not associated with acute presentation to triage (Q1 reference; Q2 aOR 0.91, 95% CI 0.65-1.28; Q3 aOR 1.09, 95% CI 0.78-1.54; Q4 aOR 1.03, 95% CI 0.73-1.44) . Higher SVI was associated with an increased odds of receipt of a complete course of betamethasone and decreased odds of adverse respiratory outcomes (Table). There was no association between the individual themes of SVI and the primary outcome, or between SVI and acuity of different presenting concerns.

Conclusion: We found no association between SVI and acuity of presentation to triage.