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Health Equity/Community Health

Poster Session 2

(467) Effects of Economic Insecurity, a Social Determinants of Health Domain, on Adverse Maternal/Neonatal Outcomes

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Adverse social determinants of health (SDoH) can impact maternal and mental health during pregnancy. Economic insecurity (EI) is one of the domains used in various frameworks of SDoH. We sought to determine the relationship between SDoH relating to EI and perinatal outcomes in a racially and ethnically diverse inner-city cohort.

Study Design: This is a prospective cross-sectional cohort of obstetrical patients delivering at an academic institution from 05/2022 to 07/2023. Structured surveys regarding various SDoH were administered in English or Spanish. The primary study exposure was defined as exposure to any adverse SDoH relating to EI including housing, income, or food insecurity during pregnancy. Sociodemographic and obstetrical characteristics were abstracted from electronic medical records.

Results: 119 patients were consented, and 85.7% (102) completed all questionnaires. Of those that completed the questionnaires, 87.2% reported EI during pregnancy. Maternal age, race/ethnicity, GA at delivery and comorbidities were similar in participants who reported EI when compared to those who did not report EI. Exposure to EI was associated with increased maternal BMI at delivery (p =0.037). Job insecurity was more common in participants with younger maternal age (p=0.024). Not surprisingly, p</span>articipants who reported EI were more likely to report food insecurity (p=0.002). Infants of participants who reported EI were more likely to require NICU admission (23.2% vs 16.7%, p=0.04), information for neonatal admission was not found for seven patients. Participants who reported EI did not report more anxiety; however, those who reported anxiety were less likely to be discharged with a contraception plan (38.5% vs 43.7%, p=0.032).

Conclusion: A large proportion of our study participants reported EI during pregnancy. Our findings suggest the need for identifying and responding to the support needs of this patient population. Further studies are needed to evaluate the role of mental health conditions on postpartum contraception, especially given the escalating risks to reproductive justice across the US.