Severe Housing Insecurity during Pregnancy: Association with Adverse Birth and Infant Outcomes
<b>Introduction:</b> 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. <b>Methods:</b> We analyzed...
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doaj-56b30047e9074bdca374a617aadf107f2020-11-25T04:02:51ZengMDPI AGInternational Journal of Environmental Research and Public Health1661-78271660-46012020-11-01178659865910.3390/ijerph17228659Severe Housing Insecurity during Pregnancy: Association with Adverse Birth and Infant OutcomesKathryn M. Leifheit0Gabriel L. Schwartz1Craig E. Pollack2Kathryn J. Edin3Maureen M. Black4Jacky M. Jennings5Keri N. Althoff6Department of Health Policy and Management, Los Angeles Fielding School of Public Health, University of California, Los Angeles, CA 90095, USAInstitute for Health Policy Studies, University of California, San Francisco School of Medicine, San Francisco, CA 94118, USADepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USADepartment of Sociology, Princeton University, Princeton, NJ 08544, USADepartment of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USADepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USADepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA<b>Introduction:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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. <b>Conclusions:</b> Results suggest that housing insecurity during pregnancy shapes neonatal and infant health in disadvantaged urban families.https://www.mdpi.com/1660-4601/17/22/8659housingevictionhomeless personsbirth weightpremature birthneonatal intensive care units |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kathryn M. Leifheit Gabriel L. Schwartz Craig E. Pollack Kathryn J. Edin Maureen M. Black Jacky M. Jennings Keri N. Althoff |
spellingShingle |
Kathryn M. Leifheit Gabriel L. Schwartz Craig E. Pollack Kathryn J. Edin Maureen M. Black Jacky M. Jennings Keri N. Althoff Severe Housing Insecurity during Pregnancy: Association with Adverse Birth and Infant Outcomes International Journal of Environmental Research and Public Health housing eviction homeless persons birth weight premature birth neonatal intensive care units |
author_facet |
Kathryn M. Leifheit Gabriel L. Schwartz Craig E. Pollack Kathryn J. Edin Maureen M. Black Jacky M. Jennings Keri N. Althoff |
author_sort |
Kathryn M. Leifheit |
title |
Severe Housing Insecurity during Pregnancy: Association with Adverse Birth and Infant Outcomes |
title_short |
Severe Housing Insecurity during Pregnancy: Association with Adverse Birth and Infant Outcomes |
title_full |
Severe Housing Insecurity during Pregnancy: Association with Adverse Birth and Infant Outcomes |
title_fullStr |
Severe Housing Insecurity during Pregnancy: Association with Adverse Birth and Infant Outcomes |
title_full_unstemmed |
Severe Housing Insecurity during Pregnancy: Association with Adverse Birth and Infant Outcomes |
title_sort |
severe housing insecurity during pregnancy: association with adverse birth and infant outcomes |
publisher |
MDPI AG |
series |
International Journal of Environmental Research and Public Health |
issn |
1661-7827 1660-4601 |
publishDate |
2020-11-01 |
description |
<b>Introduction:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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. <b>Conclusions:</b> Results suggest that housing insecurity during pregnancy shapes neonatal and infant health in disadvantaged urban families. |
topic |
housing eviction homeless persons birth weight premature birth neonatal intensive care units |
url |
https://www.mdpi.com/1660-4601/17/22/8659 |
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