Evidence map›Paper›PMID 39812889›Full record

ArticleMaternal and child health journal2025

Homelessness and Birth Outcomes in the Pregnancy Risk Assessment Monitoring System, 2016-2020.

Ashley A Meehan, Megan Steele-Baser, Aliza M Machefsky, Cynthia H Cassell, Martha P Montgomery, Emily Mosites

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Article in Maternal and child health journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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6 authors.

Ashley A MeehanDepartment of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. ameehan3@jhu.edu.ORCID http://orcid.org/0000-0002-1406-0886
Megan Steele-BaserOak Ridge Institute for Science and Education, Oak Ridge, TN, USA.
Aliza M MachefskyGilstrap Fellowship, CDC Foundation, Atlanta, GA, USA.
Cynthia H CassellDivision of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
Martha P MontgomeryDivision of Viral Hepatitis, National Center For HIV, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, GA, USA.
Emily MositesOffice of the Director, Office of Readiness and Response, CDC, Atlanta, GA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis study aimed to estimate the prevalence of homelessness shortly before or during pregnancy and describe differences in maternal characteristics and adverse birth outcomes between people reporting homelessness and not reporting homelessness.

methodsWe used 2016-2020 Pregnancy Risk Assessment Monitoring System (PRAMS) data from 31 sites to estimate the prevalence of self-reported homelessness during the 12 months before giving birth. We used logistic regression models to evaluate the association between homelessness and adverse birth outcomes, specifically small for gestational age (SGA), low birth weight (LBW), and preterm birth (PTB).

resultsOf 138,603 respondents, 4,045 reported homelessness, representing 2.4% of weighted respondents. Respondents reporting homelessness differed from respondents who did not report homelessness in maternal demographic characteristics, health conditions, behavioral and environmental risk factors, and adequacy of prenatal care. In unadjusted models, homelessness was associated with higher prevalences of SGA, LBW, and PTB (PR 1.38, 95% CI 1.21-1.57; PR 1.73, 95% CI 1.56-1.91; PR 1.42, 95% CI 1.25-1.61; respectively). After adjusting for maternal age, race and ethnicity, education, BMI, and cigarette smoking, prevalence ratios were attenuated and no longer significant. CONCLUSIONS FOR PRACTICE: Although homelessness was not independently associated with adverse birth outcomes in adjusted models, people reporting homelessness before or during pregnancy represent a group at increased risk of inadequate health care utilization and adverse birth outcomes due to other underlying demographic and social factors. Health care providers can play a critical role in identifying if patients may be experiencing homelessness and facilitating connections to social support.

Indexed as

Ill-Housed PersonsPregnancy OutcomeAdolescentAdultFemaleHumansInfant, Low Birth WeightInfant, NewbornInfant, Small for Gestational AgePregnancyPremature BirthPrenatal CarePrevalenceRisk AssessmentRisk FactorsUnited StatesHomelessnessLow birth weightPRAMSPreterm birthSmall for gestational age

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.