Homelessness during pregnancy linked to worse maternal outcomes including hypertension and diabetes: JAMA

Homelessness has significant implications for maternal, infant, and child health (MCH) and health inequities.Studies using International Classification of Diseases codes indicate that the number of postpartum people recorded as being affected by homelessness at the time of delivery is increasing over time. A multistate study using self-reported housing status demonstrated that experiencing homelessness is associated with behaviors known to affect pregnancy health (eg, smoking), but used data from 2000 to 2007.

In this cross-sectional study, we used data from the Pregnancy Risk Assessment Monitoring System (PRAMS), a multi-state cross-sectional survey designed to be representative of individuals with live births. Through mail and telephone questionnaires, and linked birth certificate data, PRAMS collects information on health, sociodemographic characteristics, and behavior. Results: In a weighted sample of 146 943 postpartum people representing a population of 8 249 272, 2.4% (95% CI 2.3%-2.5%) reported homelessness in the year before birth. Compared with those without homelessness experiences, postpartum people who experienced homelessness were more likely to report their race as Black (34.0% [95% CI, 31.8%-36.2%] vs 14.9% [95% CI, 14.7%-15.1%]), be unmarried, and have high school education or less

This cross-sectional analysis found associations between homelessness and MCH. While PRAMS data are only representative of included states, applying the 2.4% homelessness rate to all US births in 2023 implies 70 000 babies would be born within 12 months of maternal homelessness.

Reference:

McGovern ME, Treglia D, Eliason EL, Spishak-Thomas A, Cantor JC. Homelessness and Maternal and Infant Health. JAMA Netw Open. 2024;7(11):e2442596. doi:10.1001/jamanetworkopen.2024.42596

Keywords:

Homelessness, during, pregnancy, linked, worse, maternal, outcomes, including hypertension, diabetes, JAMA, McGovern ME, Treglia D, Eliason EL, Spishak-Thomas A, Cantor JC.