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Homelessness and Birth Outcomes in the Pregnancy Risk Assessment Monitoring System, 2016-2020.

Ashley A Meehan1, Megan Steele-Baser2,3, Aliza M Machefsky4,5

  • 1Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. ameehan3@jhu.edu.

Maternal and Child Health Journal
|January 15, 2025
PubMed
Summary
This summary is machine-generated.

Homelessness before or during pregnancy is linked to increased risks for adverse birth outcomes, primarily due to underlying social and demographic factors, not independently. Healthcare providers should identify and support pregnant individuals experiencing homelessness.

Keywords:
HomelessnessLow birth weightPRAMSPreterm birthSmall for gestational age

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Area of Science:

  • Reproductive Health
  • Social Determinants of Health
  • Maternal and Child Health

Background:

  • Homelessness during pregnancy is a significant public health concern.
  • Understanding the association between homelessness and adverse birth outcomes is crucial for targeted interventions.

Purpose of the Study:

  • To estimate the prevalence of homelessness before or during pregnancy.
  • To examine the relationship between homelessness and adverse birth outcomes, including small for gestational age, low birth weight, and preterm birth.
  • To describe maternal characteristics associated with homelessness.

Main Methods:

  • Utilized 2016-2020 Pregnancy Risk Assessment Monitoring System (PRAMS) data from 31 sites.
  • Analyzed self-reported homelessness in the 12 months preceding childbirth.
  • Employed logistic regression to assess associations between homelessness and adverse birth outcomes (SGA, LBW, PTB).

Main Results:

  • Approximately 2.4% of respondents reported homelessness.
  • Homeless individuals exhibited differences in demographics, health conditions, risk factors, and prenatal care adequacy.
  • Unadjusted analyses showed higher prevalences of SGA, LBW, and PTB among homeless individuals, but these associations were not significant after adjustment for covariates.

Conclusions:

  • Homelessness itself was not independently associated with adverse birth outcomes in adjusted models.
  • Pregnant individuals experiencing homelessness are at higher risk due to underlying social and demographic factors.
  • Healthcare providers play a vital role in identifying and connecting patients experiencing homelessness to social support services.