Social Determinants of Health Needs and Perinatal Risk in Socially Vulnerable Pregnant Patients

Objectives. To understand perinatal risks associated with social needs in preg-nancy Methods. Multivariable log-binomial regression analyses adjusting for age, parity, and insurance were used to evaluate the relationship between any social need (e.g., hous-ing, transportation, food, and intimate partner violence) and adverse perinatal outcomes (stillbirth, prematurity, maternal morbidity) in a cohort of English and Spanish-speaking patients who obtained prenatal care and birthed at our institution during a one -year period. Results. Of 2,435 patients, 1,608 (66%) completed social needs screening at least once during prenatal care. The cohort was predominantly non-Hispanic Black (1,294, 80%) and publicly insured (1,395, 87%). Having one or more social need was associated with three -fold increased risk of stillbirth (aRR 3.35, 95%CI 1.31,8.6) and 14% reduction in postpartum care attendance (aRR 0.86, 95%CI 0.78- 0.95) and was highest in individuals reporting transportation needs. Conclusions. Social needs during pregnancy were associ-ated with increased risk of stillbirth.