Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Household unmet basic needs in the first 1000 days and preterm birth status

Journal of Perinatology volume 42, pages 389–396 (2022)Cite this article

Subjects

Abstract

Objective

To examine the relationship of individual and composite number of unmet basic needs (housing, energy, food, and healthcare hardships) in the past year with preterm birth status among children aged 0–24 months.

Study design

We examined cross-sectional 2011–18 data of 17,926 families with children aged 0–24 months. We examined children born <31 weeks’, 31–33 weeks’, and 34–36 weeks’ gestation versus term (≥37 weeks) using multivariable multinomial logistic regression.

Results

At least 1 unmet basic need occurred among ≥60% of families with preterm children, compared to 56% of families with term children (p = 0.007). Compared to term, children born ≤30 weeks’ had increased odds of healthcare hardships (aOR 1.28 [1.04, 1.56]) and children born 34–36 weeks’ had increased odds of 1 (aOR 1.19 [1.05, 1.35]) and ≥2 unmet needs (aOR 1.15 [1.01, 1.31]).

Conclusion

Unmet basic needs were more common among families with preterm, compared to term children.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. US Census Bureau. Income and Poverty in the United States: 2018. The United States Census Bureau. https://www.census.gov/data/tables/2019/demo/income-poverty/p60-266.html. Accessed 20 Mar 2021.

  2. Marmot M. Social determinants of health inequalities. Lancet. 2005;365:1099–104.

    Article  PubMed  Google Scholar 

  3. Braveman P, Egerter S, Williams DR. The social determinants of health: coming of age. Annu Rev Public Health. 2011;32:381–98. https://doi.org/10.1146/annurev-publhealth-031210-101218

    Article  PubMed  Google Scholar 

  4. Schwarzenberg SJ, Georgieff MK, Nutrition CO. Advocacy for improving nutrition in the first 1000 days to support childhood development and adult health. Pediatrics. 2018;141. https://doi.org/10.1542/peds.2017-3716

  5. Miller GE, Chen E. The biological residue of childhood poverty. Child Dev Perspect. 2013;7:67–73.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Hoynes H, Schanzenbach DW, Almond D. Long-run impacts of childhood access to the safety net. Am Economic Rev. 2016;106:903–34.

    Article  Google Scholar 

  7. Metallinos-Katsaras E, Must A, Gorman K. A longitudinal study of food insecurity on obesity in preschool children. J Acad Nutr Diet. 2012;112:1949–58.

    Article  PubMed  Google Scholar 

  8. Woo Baidal JA, Locks LM, Cheng ER, Blake-Lamb TL, Perkins ME, Taveras EM. Risk factors for childhood obesity in the first 1000 days: a systematic review. Am J Prev Med. 2016;50:761–79.

    Article  PubMed  Google Scholar 

  9. Council on Community Pediatrics. Poverty and child health in the United States. Pediatrics. 2016;137. https://doi.org/10.1542/peds.2016-0339

  10. Fritz CQ, Thomas J, Gambino J, Torok M, Brittan MS. Prevalence of social risks on inpatient screening and their impact on pediatric care use. Hosp Pediatr. 2020;10:859–66.

    Article  PubMed  Google Scholar 

  11. Martin JA. Births in the United States, 2018. 2019. p. 8. https://www.cdc.gov/nchs/data/databriefs/db318.pdf. Accessed 1 Sept 2021.

  12. Institute of Medicine (US) Committee on understanding premature birth and assuring healthy outcomes. Preterm birth: causes, consequences, and prevention. (Behrman RE, Butler AS, eds.). National Academies Press (US); 2007. http://www.ncbi.nlm.nih.gov/books/NBK11362/. Accessed 20 Mar 2021.

  13. Allotey J, Zamora J, Cheong-See F, Kalidindi M, Arroyo-Manzano D, Asztalos E, et al. Cognitive, motor, behavioural and academic performances of children born preterm: a meta-analysis and systematic review involving 64 061 children. BJOG. 2018;125:16–25.

    Article  CAS  PubMed  Google Scholar 

  14. Wallace ME, Mendola P, Chen Z, Hwang BS, Grantz KL. Preterm birth in the context of increasing income inequality. Matern Child Health J. 2016;20:164–71.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Shah P, Kaciroti N, Richards B, Oh W, Lumeng JC. Developmental outcomes of late preterm infants from infancy to kindergarten. Pediatrics. 2016;138. https://doi.org/10.1542/peds.2015-3496

  16. Woythaler M. Neurodevelopmental outcomes of the late preterm infant. Semin Fetal Neonatal Med. 2019;24:54–59.

    Article  PubMed  Google Scholar 

  17. Yaari M, Mankuta D, Harel-Gadassi A, Friedlander E, Bar-Oz B, Eventov-Friedman S, et al. Early developmental trajectories of preterm infants. Res Dev Disabil. 2018;81:12–23.

    Article  PubMed  Google Scholar 

  18. Joseph RM, O’Shea TM, Allred EN, Heeren T, Kuban KK. Maternal educational status at birth, maternal educational advancement, and neurocognitive outcomes at age 10 years among children born extremely preterm. Pediatr Res. 2018;83:767–77.

    Article  PubMed  Google Scholar 

  19. Lean RE, Paul RA, Smyser TA, Smyser CD, Rogers CE. Social adversity and cognitive, language, and motor development of very preterm children from 2 to 5 years of age. J Pediatr. 2018;203:177–184.e1.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Mani A, Mullainathan S, Shafir E, Zhao J. Poverty impedes cognitive function. Science. 2013;341:976–80.

    Article  CAS  PubMed  Google Scholar 

  21. Treyvaud K, Lee KJ, Doyle LW, Anderson PJ. Very preterm birth influences parental mental health and family outcomes seven years after birth. J Pediatr. 2014;164:515–21.

    Article  PubMed  Google Scholar 

  22. Sandel M, Sheward R, de Cuba SE, Coleman SM, Frank DA, Childton M, et al. Unstable housing and caregiver and child health in renter families. Pediatrics. 2018;141. https://doi.org/10.1542/peds.2017-2199.

  23. Cook JT, Frank DA, Casey PH, Rose-Jacobs R, Black MM, Chilton M, et al. A brief indicator of household energy security: associations with food security, child health, and child development in US infants and toddlers. Pediatrics. 2008;122:e867–75.

    Article  PubMed  Google Scholar 

  24. Cutts DB, Coleman S, Black MM, Chilton MM, Cook JT, Ettinger de Cuba S, et al. Homelessness during pregnancy: a unique, time-dependent risk factor of birth outcomes. Matern Child Health J. 2015;19:1276–83.

    Article  PubMed  Google Scholar 

  25. Rhee J, Fabian MP, Ettinger de Cuba S, Coleman S, Sandel M, James Lane K, et al. Effects of maternal homelessness, supplemental nutrition programs, and prenatal PM2.5 on birthweight. Int J Environ Res Public Health. 2019;16. https://doi.org/10.3390/ijerph16214154

  26. Mousa A, Naqash A, Lim S. Macronutrient and micronutrient intake during pregnancy: an overview of recent evidence. Nutrients. 2019;11. https://doi.org/10.3390/nu11020443

  27. Coleman-Jensen A, Rabbitt MP, Gregory CA, Singh A. Household food security in the United States in 2017. Economic Research Report No. (ERR-256). 2017. p. 44. https://www.ers.usda.gov/publications/pub-details/?pubid=90022. Accessed 1 Sep 2021.

  28. United States Department of Agriculture. Guide to measuring household food security. 2000. https://naldc.nal.usda.gov/download/38369/PDF. Accessed 1 Sep 2021.

  29. Ettinger de Cuba SMD, Fix G, Raifman J, Cutts D, Bovell-Ammon A, Coleman S, et al. Health care hardship among young US-born children of us-born and immigrant mothers may put children at risk. Published online July 2020.

  30. Schaaf JM, Liem SMS, Mol BWJ, Abu-Hanna A, Ravelli ACJ. Ethnic and racial disparities in the risk of preterm birth: a systematic review and meta-analysis. Am J Perinatol. 2013;30:433–50.

    PubMed  Google Scholar 

  31. Schempf AH, Branum AM, Lukacs SL, Schoendorf KC. Maternal age and parity-associated risks of preterm birth: differences by race/ethnicity. Paediatr Perinat Epidemiol. 2007;21:34–43.

    Article  PubMed  Google Scholar 

  32. El-Sayed AM, Galea S. Temporal changes in socioeconomic influences on health: maternal education and preterm birth. Am J Public Health. 2012;102:1715–21.

    Article  PubMed  PubMed Central  Google Scholar 

  33. El-Sayed AM, Tracy M, Galea S. Life course variation in the relation between maternal marital status and preterm birth. Ann Epidemiol. 2012;22:168–74.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Frank DA, Casey PH, Black MM, Rose-Jacobs R, Chilton M, Cutts D, et al. Cumulative hardship and wellness of low-income, young children: multisite surveillance study. Pediatrics. 2010;125:e1115–23.

    Article  PubMed  Google Scholar 

  35. Swearingen C, Simpson P, Cabacungan E, Cohen S. Social disparities negatively impact neonatal follow-up clinic attendance of premature infants discharged from the neonatal intensive care unit. J Perinatol. 2020;40:790–7.

    Article  PubMed  Google Scholar 

  36. Garg A, Butz AM, Dworkin PH, Lewis RA, Thompson RE, Serwint JR. Improving the management of family psychosocial problems at low-income children’s well-child care visits: the WE CARE Project. Pediatrics. 2007;120:547–58.

    Article  PubMed  Google Scholar 

  37. Garg A, Toy S, Tripodis Y, Silverstein M, Freeman E. Addressing social determinants of health at well child care visits: a cluster RCT. Pediatrics. 2015;135:e296–304.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Garg A, Homer CJ, Dworkin PH. Addressing social determinants of health: challenges and opportunities in a value-based model. Pediatrics. 2019;143. https://doi.org/10.1542/peds.2018-2355

  39. Vasan A, Kenyon CC, Palakshappa D. Differences in pediatric residents’ social needs screening practices across health care settings. Hosp Pediatr. 2020;10:443–6.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Lakshmanan A, Agni M, Lieu T, Fleegler E, Kipke M, Friedlich PS, et al. The impact of preterm birth <37 weeks on parents and families: a cross-sectional study in the 2 years after discharge from the neonatal intensive care unit. Health Qual Life Outcomes. 2017;15. https://doi.org/10.1186/s12955-017-0602-3

  41. Berman L, Raval MV, Ottosen M, Mackow AK, Cho M, Goldin AB. Parent perspectives on readiness for discharge home after neonatal intensive care unit admission. J Pediatr. 2019;205:e4

    Article  Google Scholar 

  42. Lakshmanan A, Kubicek K, Williams R, Robles M, Vanderbilt DL, Mirzaian CB, et al. Viewpoints from families for improving transition from NICU-to-home for infants with medical complexity at a safety net hospital: a qualitative study. BMC Pediatr. 2019;19:223

    Article  PubMed  PubMed Central  Google Scholar 

  43. Clark RE, Weinreb L, Flahive JM, Seifert RW. Homelessness contributes to pregnancy complications. Health Aff. 2019;38:139–46.

    Article  Google Scholar 

  44. Dolatian M, Sharifi N, Mahmoodi Z. Relationship of socioeconomic status, psychosocial factors, and food insecurity with preterm labor: a longitudinal study. Int J Reprod Biomed. 2018;16:563–70.

    PubMed  PubMed Central  Google Scholar 

  45. Gadson A, Akpovi E, Mehta PK. Exploring the social determinants of racial/ethnic disparities in prenatal care utilization and maternal outcome. Semin Perinatol. 2017;41:308–17.

    Article  PubMed  Google Scholar 

  46. Beck AF, Edwards EM, Horbar JD, Howell EA, McCormick MC, Pursley DM. The color of health: how racism, segregation, and inequality affect the health and well-being of preterm infants and their families. Pediatr Res. 2020;87:227–34.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We thank the families who participated in the Children’s HealthWatch survey and shared their experiences with us. This study was funded in part by the grant R01MD007793 from the National Institute on Minority Health and Health Disparities (NIMMD) and supporters of the Children’s HealthWatch https://childrenshealthwatch.org/giving/supporters/

Author information

Authors and Affiliations

  1. Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA

    Margaret G. Parker, Stephanie Ettinger de Cuba, Megan T. Sandel & Deborah A. Frank

  2. Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, USA

    Lindsey J. Rateau

  3. Department of Pediatrics, Hennepin County Medical Center, Boston, MA, USA

    Diana B. Cutts

  4. Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA

    Timothy C. Heeren

  5. Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA

    Félice Lê-Scherban

  6. Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA

    Maureen M. Black

  7. RTI International, Research Triangle Park, NC, USA

    Maureen M. Black

  8. Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Eduardo R. Ochoa Jr

  9. Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, USA

    Arvin Garg

Authors
  1. Margaret G. Parker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stephanie Ettinger de Cuba
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lindsey J. Rateau
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Megan T. Sandel
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Deborah A. Frank
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Diana B. Cutts
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Timothy C. Heeren
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Félice Lê-Scherban
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Maureen M. Black
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Eduardo R. Ochoa Jr
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Arvin Garg
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Parker conceptualized and designed the study, interpreted the data, drafted the initial manuscript, and reviewed and revised the manuscript. Ms. Rateau conducted the analysis, interpreted the data, and critically revised the manuscript for important intellectual content. Garg, Sandel, Cutts, Frank, Lê-Scherban, Ochoa, and Black interpreted the data and critically revised the manuscript for important intellectual content. Ettinger de Cuba and Heeren conceptualized and designed the study, interpreted the data, and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Margaret G. Parker.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Parker, M.G., de Cuba, S.E., Rateau, L.J. et al. Household unmet basic needs in the first 1000 days and preterm birth status. J Perinatol 42, 389–396 (2022). https://doi.org/10.1038/s41372-022-01325-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41372-022-01325-5

This article is cited by

Search

Advanced search

Quick links