2016-2020年怀孕风险评估监测系统中的无家可归者和出生结果。

IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Ashley A Meehan, Megan Steele-Baser, Aliza M Machefsky, Cynthia H Cassell, Martha P Montgomery, Emily Mosites
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引用次数: 0

摘要

目的:本研究旨在估计怀孕前不久或怀孕期间无家可归的流行程度,并描述报告无家可归者和未报告无家可归者之间孕产妇特征和不良分娩结果的差异。方法:利用2016-2020年妊娠风险评估监测系统(PRAMS)的31个站点的数据,估计分娩前12个月自我报告的无家可归率。我们使用逻辑回归模型来评估无家可归与不良出生结局之间的关系,特别是小胎龄(SGA)、低出生体重(LBW)和早产(PTB)。结果:在138,603名受访者中,4,045人报告无家可归,占加权受访者的2.4%。报告无家可归的答复者与未报告无家可归的答复者在产妇人口特征、健康状况、行为和环境风险因素以及产前护理是否充足等方面存在差异。在未经调整的模型中,无家可归与SGA、LBW和PTB的较高患病率相关(PR 1.38, 95% CI 1.21-1.57;Pr 1.73, 95% ci 1.56-1.91;Pr 1.42, 95% ci 1.25-1.61;分别)。在调整了母亲年龄、种族和民族、教育程度、BMI和吸烟等因素后,患病率有所降低,不再显著。实践结论:虽然在调整后的模型中,无家可归与不良分娩结果没有独立关联,但报告在怀孕前或怀孕期间无家可归的人,由于其他潜在的人口和社会因素,代表了一个医疗保健利用不足和不良分娩结果风险更高的群体。卫生保健提供者可以在确定患者是否可能无家可归和促进与社会支持的联系方面发挥关键作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Homelessness and Birth Outcomes in the Pregnancy Risk Assessment Monitoring System, 2016-2020.

Objectives: This study aimed to estimate the prevalence of homelessness shortly before or during pregnancy and describe differences in maternal characteristics and adverse birth outcomes between people reporting homelessness and not reporting homelessness.

Methods: We used 2016-2020 Pregnancy Risk Assessment Monitoring System (PRAMS) data from 31 sites to estimate the prevalence of self-reported homelessness during the 12 months before giving birth. We used logistic regression models to evaluate the association between homelessness and adverse birth outcomes, specifically small for gestational age (SGA), low birth weight (LBW), and preterm birth (PTB).

Results: Of 138,603 respondents, 4,045 reported homelessness, representing 2.4% of weighted respondents. Respondents reporting homelessness differed from respondents who did not report homelessness in maternal demographic characteristics, health conditions, behavioral and environmental risk factors, and adequacy of prenatal care. In unadjusted models, homelessness was associated with higher prevalences of SGA, LBW, and PTB (PR 1.38, 95% CI 1.21-1.57; PR 1.73, 95% CI 1.56-1.91; PR 1.42, 95% CI 1.25-1.61; respectively). After adjusting for maternal age, race and ethnicity, education, BMI, and cigarette smoking, prevalence ratios were attenuated and no longer significant.

Conclusions for practice: Although homelessness was not independently associated with adverse birth outcomes in adjusted models, people reporting homelessness before or during pregnancy represent a group at increased risk of inadequate health care utilization and adverse birth outcomes due to other underlying demographic and social factors. Health care providers can play a critical role in identifying if patients may be experiencing homelessness and facilitating connections to social support.

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来源期刊
Maternal and Child Health Journal
Maternal and Child Health Journal PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
3.20
自引率
4.30%
发文量
271
期刊介绍: Maternal and Child Health Journal is the first exclusive forum to advance the scientific and professional knowledge base of the maternal and child health (MCH) field. This bimonthly provides peer-reviewed papers addressing the following areas of MCH practice, policy, and research: MCH epidemiology, demography, and health status assessment Innovative MCH service initiatives Implementation of MCH programs MCH policy analysis and advocacy MCH professional development. Exploring the full spectrum of the MCH field, Maternal and Child Health Journal is an important tool for practitioners as well as academics in public health, obstetrics, gynecology, prenatal medicine, pediatrics, and neonatology. Sponsors include the Association of Maternal and Child Health Programs (AMCHP), the Association of Teachers of Maternal and Child Health (ATMCH), and CityMatCH.
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