Postpartum Implications of Screening for Social Determinants of Health at the Time of Delivery

The Illinois Perinatal Quality Collaborative (ILPQC) aims to enhance perinatal care in Illinois. However, up to 50% of women do not attend postpartum care. This study assessed the impact of universal screening for social determinants of health (SDoH) during labor and delivery on postpartum care attendance.

A retrospective chart review was conducted for women who delivered at a large academic medical center. The study received exempt status from Loyola University Institutional Review Board. Universal SDoH screening was implemented in March 2022. Data were collected from a control group (six months pre-implementation) and an intervention group (six months post-implementation). The primary outcome was attendance at both scheduled postpartum visits. Comparisons were made using Pearson chi-square for categorical variables and ANOVA for continuous variables. Finally, a multinomial regression model, adjusted for patient characteristics, was used to estimate the effect of universal screening on postpartum appointment attendance. Significance was set at p < .05.

The sample included 1,098 women, with 541 in the control group and 557 in the intervention group. The SDoH screening completion rate was 75.0% (n = 415). Basic demographics were similar, with minor differences addressed in regression models. Women in the intervention group were 1.69 times more likely to attend both postpartum visits (RRR = 1.69, 95% CI [1.14, 2.51], p = .009) compared to those in the control group.

Implementing SDoH screening at our hospital improved postpartum visit attendance.