Born into homelessness: A retrospective observational study

To evaluate the differences in the antenatal and neonatal courses of maternal-infant dyads within a homeless population as compared to the general hospital population.

This was a retrospective observational study.

A large single tertiary maternity hospital (8500 deliveries/year) in Ireland.

We retrospectively reviewed perinatal outcomes for homeless women who delivered liveborn infants at a tertiary maternity hospital, during the calendar year 2020. Homelessness was defined as either A) A designated homeless accommodation service listed as the home address; or B) Self-identified as homeless with an address other than homeless accommodation. We then compared the study cohort with the general hospital population who delivered liveborn infants in the year 2020.

A set of key clinical variables (maternal, antenatal, birth and postnatal outcomes) were obtained and descriptive statistics were performed and compared to available hospital wide data.

A total population of 145 infants born to 143 homeless mothers were included. Compared with the general hospital population, infants born into homelessness were more likely to be born preterm (15 % vs 7 %), with lower median birth weight (3.1 kg vs 3.4 kg) and higher rates of admission to the neonatal unit (35 % vs 14 %). Following discharge, there was a greater incidence of missed appointments to the neonatal clinic (29 % vs 8 %), and lower rates of exclusive breastfeeding (16 % vs 45 %).

Addressing societal inequalities starts before birth. Infants born into homelessness are particularly vulnerable to perinatal factors associated with negative long-term outcomes when compared with the general population.