Trends and outcomes of delivery hospitalizations with unstable housing, 2000–2018

Abstract

Purpose: Data on trends in and implications of unstable housing during pregnancy are limited. The purpose of this study was to address these knowledge gaps.

Methods: This repeat cross-sectional study using the National Inpatient Sample analyzed unstable housing diagnoses among 2000–2018 delivery hospitalizations. Joinpoint regression was used to estimate trends in unstable housing by calculating the average annual percent change.

Results: From 2000 to 2018, 27,984 delivery hospitalizations had associated diagnoses of unstable housing (0.03%). There was a significant increase in the unstable housing rates, from 0.72 per 10,000 deliveries in 2000 to 12.8 per 10,000 deliveries in 2018. Delivery hospitalizations with unstable housing were at significantly higher risk of antepartum hemorrhage, preterm delivery, hypertensive disorders of pregnancy, postpartum hemorrhage, and severe maternal morbidity than those without.

Conclusions: This serial cross-sectional analysis of delivery hospitalizations found that the reported prevalence of unstable housing is low but increasing and associated with adverse outcomes.

Keywords:

• Unstable housing
• maternal outcomes
• social determinants of health
• maternal safety
• disparities

Ethical approval

This analysis was deemed exempt by the Columbia University Institutional Review Board (AAAE8144).

Disclosure statement

Dr. D’Alton had a senior leadership role in ACOG II’s Safe Motherhood Timothy Wen reports receiving funding from Delfina Care Inc. as an advisor on their medical advisory board, and he has equity in the company. Initiative which received unrestricted funding from Merck for Mothers. The other authors did not report any potential conflicts of interest.