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Homelessness in pregnancy: perinatal outcomes

Journal of Perinatology volume 41, pages 2742–2748 (2021)Cite this article

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Abstract

Objective

Investigate the association between maternal homelessness at the time of delivery and perinatal outcomes, with a focus on neonatal health outcomes.

Study design

Population-based cohort using California’s statewide database included 1,520,253 women with linked birth and maternal discharge data, 2008–2012. Multivariable analysis assessed homelessness at time of delivery on perinatal outcomes, preterm delivery, and neonatal intensive care unit admission.

Result

A total of 672 women (0.05%) were homeless at the time of delivery. Homelessness was associated with premature delivery at multiple gestational age cutoffs (34w0d–36w6d; 32w0d–33w6d; 28w0d–31w6d; <28w0d) (range of aORs:1.62–2.19), and neonatal intensive care unit admission (aOR = 1.66, 95% CI:1.31–2.09). Among term infants, homelessness remained associated with increased odds of neonatal intensive care unit admission (aOR = 1.84, 95% CI:1.34–2.53), low birthweight (aOR = 1.99, 95% CI:1.36–2.90), neonatal abstinence syndrome (aOR = 2.13, 95% CI:1.35–2.53), hypoxic-ischemic encephalopathy (aOR = 14.38, 95% CI:3.90–53.01), and necrotizing enterocolitis (aOR = 14.94, 95% CI:2.68–83.20).

Conclusion

Homelessness in pregnancy was associated with adverse perinatal outcomes including increased odds of preterm delivery across all gestational ages, and increased risk of neonatal intensive care unit admission and low birth weight independent of preterm delivery.

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Fig. 1: Inclusion criteria for study population.

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Author information

Author notes

  1. These authors contributed equally: Brad S. St. Martin, Ariana M. Spiegel.

Authors and Affiliations

  1. Department of Obstetrics & Gynecology, Stanford University, Stanford, CA, USA

    Brad S. St. Martin, Ariana M. Spiegel, Stephanie A. Leonard, Anna I. Girsen & Yasser Y. El-Sayed

  2. California Perinatal Quality Care Collaborative, Stanford, CA, USA

    Lillian Sie

  3. Department of Pediatrics,, Stanford University, Stanford, CA, USA

    Lillian Sie & Gary M. Shaw

  4. Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA

    Dominika Seidman

  5. March of Dimes Prematurity Center, Stanford, CA, USA

    Gary M. Shaw

Authors
  1. Brad S. St. Martin
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  8. Yasser Y. El-Sayed
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Contributions

BSS, AMS, LS, SAL, DS, AIG, GMS, and YYS contributed to the design and implementation of the research, to the analysis of the results and to the writing of the paper.

Corresponding author

Correspondence to Brad S. St. Martin.

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The authors declare no competing interests.

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St. Martin, B.S., Spiegel, A.M., Sie, L. et al. Homelessness in pregnancy: perinatal outcomes. J Perinatol 41, 2742–2748 (2021). https://doi.org/10.1038/s41372-021-01187-3

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