Journal article
Severe Housing Insecurity during Pregnancy: Association with Adverse Birth and Infant Outcomes
International journal of environmental research and public health, v 17(22), pp 1-12
21 Nov 2020
PMID: 33233450
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Introduction: Housing insecurity is increasingly commonplace among disadvantaged women and children. We measured the individual- and population-level impact of severe housing insecurity during pregnancy on adverse birth and infant outcomes. Methods: We analyzed data from 3428 mother-infant dyads enrolled in the Fragile Families and Child Wellbeing Study, a prospective cohort study representing births in 20 large U.S. cities from 1998 to 2000. Severe housing insecurity was defined as threatened eviction or homelessness during pregnancy. Outcomes included low birth weight and/or preterm birth, admission to a neonatal intensive care unit (NICU) or stepdown facility, extended hospitalization after delivery, and infant health and temperament. We estimated exposure-outcome associations with risk ratios adjusted for pre-pregnancy maternal sociodemographic and heath factors and calculated a population attributable fraction (PAF) of outcomes attributable to severe housing insecurity. Results: We found statistically significant associations between severe housing insecurity during pregnancy and low birth weight and/or preterm birth (risk ratio (RR] 1.73, 95% confidence interval (CI) 1.28, 2.32), NICU or stepdown stay (RR 1.64, CI 1.17, 2.31), and extended hospitalization (RR 1.66, CI 1.28, 2.16). Associations between housing insecurity and infant fair or poor health (RR 2.62, CI 0.91, 7.48) and poor temperament (RR 1.52, CI 0.98, 2.34) were not statistically significant. PAF estimates ranged from 0.9-2.7%, suggesting that up to three percent of adverse birth and infant outcomes could be avoided by eliminating severe housing insecurity among low-income, pregnant women in US cities. Conclusions: Results suggest that housing insecurity during pregnancy shapes neonatal and infant health in disadvantaged urban families.
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Details
- Title
- Severe Housing Insecurity during Pregnancy: Association with Adverse Birth and Infant Outcomes
- Creators
- Kathryn M. Leifheit - University of California, Los AngelesGabriel L. Schwartz - University of California, San FranciscoCraig E. Pollack - Johns Hopkins UniversityKathryn J. Edin - Princeton UniversityMaureen M. Black - University of Maryland, BaltimoreJacky M. Jennings - Johns Hopkins UniversityKeri N. Althoff - Johns Hopkins University
- Publication Details
- International journal of environmental research and public health, v 17(22), pp 1-12
- Publisher
- Mdpi
- Number of pages
- 12
- Grant note
- R01ES026170 / National Institute for Environmental Health Sciences; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Environmental Health Sciences (NIEHS) R01HD36916; R01HD39135; R01HD40421 / National Institute of Child Health and Human Development (NICHD); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) R25HD074544; F31HD096767; R03HD098411 / NICHD; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) 2T32HS000046 / Agency for Healthcare Research and Quality Post-Doctoral Fellowship
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative; Health Management and Policy
- Web of Science ID
- WOS:000594748900001
- Scopus ID
- 2-s2.0-85096371099
- Other Identifier
- 991021871327004721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Environmental Sciences
- Public, Environmental & Occupational Health