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Short Interpregnancy Intervals Among Women Experiencing Homelessness in Colorado.

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Summary

Women experiencing homelessness have higher odds of short interpregnancy intervals (SIPIs). Interventions must address conception management and consider racial and ethnic disparities for homeless populations.

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Area of Science:

  • Reproductive Health
  • Health Disparities
  • Public Health

Background:

  • Short interpregnancy intervals (SIPIs) are linked to adverse maternal and neonatal outcomes.
  • Existing research indicates socioeconomic disparities in SIPIs, but data on homeless women are limited.

Purpose of the Study:

  • To compare SIPI rates and characteristics between homeless and domiciled women.
  • To examine how homelessness influences the association between SIPIs and race/ethnicity.
  • To assess if very short interpregnancy intervals (VSIPIs) impact maternal/neonatal outcomes differently based on housing status.

Main Methods:

  • A Colorado statewide cohort study linked multiple databases (claims, homeless management, vital records).
  • Included women who gave birth between January 1, 2016, and December 31, 2021.
  • Analyzed data on homelessness, race/ethnicity, SIPIs, and maternal/neonatal outcomes.

Main Results:

  • Homelessness was associated with increased odds of SIPIs (AOR, 1.23).
  • The association between homelessness and SIPIs was smaller for non-Hispanic Black and White women compared to Hispanic women.
  • VSIPIs showed a greater association with emergency department visits and low birth weight among homeless women, though not statistically significant.

Conclusions:

  • Homelessness is associated with a higher likelihood of short interpregnancy intervals.
  • Conception management is crucial for women experiencing homelessness.
  • Interventions should address racial and ethnic disparities in SIPIs among this population.