LATEBREAKER
Health Disparities
The Effect of Social Deprivation on Adverse Pregnancy Outcomes Akaninyene Noah* Akaninyene Noah Brandie DePaoli Taylor Ashley Hill
Background
Socioeconomic factors have been linked to adverse pregnancy outcomes; however, there has been limited emphasis on the accumulative effect of multiple neighborhood-level risk factors on birth outcomes. The social deprivation index [SDI] is a commonly used measure of assessing area-level socioeconomic disadvantage. We hypothesize that women from locations with higher SDI scores have a higher risk of adverse pregnancy outcomes, specifically preeclampsia (PE), gestational diabetes [GDM], and preterm birth [PTB].
Methods
We conducted a retrospective cohort study of 41,834 singleton pregnancies between 2011 and 2024, using data from a perinatal database from Houston, TX. We linked patients’ preconception zip codes with the SDI score associated with that zip code, using data from the American Community Survey. Pregnancies were categorized based on SDI score into 4 quartiles, where SDI Q1 were the least deprived and SDI Q4 was most deprived. Pregnancies from SDI Q1 were used as our reference group; our outcomes include PE, GDM and PTB. A modified Poisson regression model was used to calculate the relative risk and 95% confidence interval between SDI quartiles and our outcomes. Models were adjusted for age, education, payment method, chronic health issues, smoking, and gravidity.
Results
About 50% of our population was Hispanic and used Medicaid as their primary payment option. Adjusted models showed SDI Q2 (RR 1.09, 95% CI 1.00 – 1.21), SDI Q3 (RR 1.11, 95% CI 1.02 – 1.21) and SDI Q4 (RR 1.12, 95%CI 1.02 – 1.23) were associated with an increased risk of PE. We observed the same patterns with GDM. However, there was no association among any SDI quartile – SDI Q2 (RR 1.02, 95% CI 0.94-1.10), SDI Q3(RR 0.94, 95%CI 0.86 – 1.02), SDI Q4 (RR 0.95, 95% CI 0.87-1.04) – with PTB.
Conclusion
We found evidence that social deprivation was associated with PE and GDM. Additional research is needed to further explore which social factors appear to be driving the association.
