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A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
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County-Level Maternal Vulnerability and Preterm Birth in the US.

Elizabeth G Salazar1,2, Diana Montoya-Williams1,2,3, Molly Passarella1

  • 1Division of Neonatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

JAMA Network Open
|May 25, 2023
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Summary

The Maternal Vulnerability Index (MVI) is linked to preterm birth (PTB) risk. Higher MVI scores indicate increased PTB, especially extreme PTB, highlighting community factors in perinatal health.

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Area of Science:

  • Perinatal Health
  • Social Epidemiology
  • Public Health Policy

Background:

  • Community conditions significantly impact maternal and infant health outcomes.
  • Existing research lacks specific maternal health indices to assess community-level risks for preterm birth (PTB).

Purpose of the Study:

  • To evaluate the association between the Maternal Vulnerability Index (MVI), a novel county-level measure, and the incidence of PTB.

Main Methods:

  • Retrospective cohort study utilizing US Vital Statistics data (2018).
  • Included over 3.6 million singleton births.
  • Analyzed associations between MVI (overall and by 6 themes) and PTB using multivariable logistic regression.

Main Results:

  • A higher MVI was associated with increased PTB risk (adjusted OR, 1.07).
  • The MVI demonstrated the strongest association with extreme PTB (adjusted OR, 1.18).
  • Specific MVI themes (physical health, mental health/substance abuse, health care) were linked to PTB.

Conclusions:

  • The MVI effectively quantifies county-level PTB risk, independent of individual factors.
  • Findings suggest the MVI can inform public health policies aimed at reducing PTB and improving perinatal outcomes.