Maternal Vulnerability Index and Severe Maternal Morbidity.

Area of Science:

• Public Health
• Epidemiology
• Maternal Health

Background:

• Few studies have explored composite neighborhood social determinants of health and severe maternal morbidity (SMM).
• No research has examined SMM using indices specifically tailored to maternal health.

Purpose of the Study:

• To examine the association between the Maternal Vulnerability Index (MVI) and SMM.
• To assess the MVI's utility in identifying maternal risk for adverse health outcomes.

Main Methods:

• Retrospective, population-based cohort study across 5 US states (2008-2020).
• Included over 6.5 million individuals delivering a fetal death or live birth.
• MVI scores and themes were analyzed in quartiles based on residential zip code tabulation areas.

Main Results:

• No association was found between MVI score/themes and SMM during delivery hospitalization.
• A dose-response association was observed between higher MVI scores and SMM within 42 days postpartum.
• Specific MVI themes (general health care, physical environment, physical health, reproductive health care, socioeconomic determinants) were associated with postpartum SMM.

Conclusions:

• MVI scores are not associated with SMM during delivery but are linked to postpartum SMM.
• The MVI may be more effective at capturing long-term risks than acute conditions during delivery hospitalization.