Evidence map›Paper›PMID 41024747›Full record

Observational studyBJOG : an international journal of obstetrics and gynaecology2025

Neighbourhood Socioeconomic Disadvantage and Severe Maternal Morbidity: Secondary Analysis of a Prospective Cohort.

T Caroline Bank, Janet Catov, Jiqiang Wu, Lynn M Yee, David M Haas, Rebecca McNeil, Jessica Pippen, Hyagriv N Simhan, Uma Reddy, Robert M Silver and 6 more

Abstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BJOG : an international journal of obstetrics and gynaecology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Area deprivation, social vulnerability, and post-pregnancy blood pressure.medRxiv : the preprint server for health sciences · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

T Caroline BankDepartment of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, USA.ORCID https://orcid.org/0000-0002-9961-5915
Janet CatovDepartment of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Jiqiang WuDepartment of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, USA.
Lynn M YeeDepartment of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois, USA.
David M HaasDepartment of Obstetrics and Gynecology, Indiana University, Indianapolis, Indiana, USA.
Rebecca McNeilRTI International, Durham, North Carolina, USA.
Jessica PippenDepartment of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, Ohio, USA.
Hyagriv N SimhanDepartment of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Uma ReddyDepartment of Obstetrics and Gynecology, Columbia University, New York, New York, USA.
Robert M SilverDepartment of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah, USA.
Lisa LevineDepartment of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
George SaadeDepartment of Obstetrics and Gynecology, Eastern Virginia Medical College, Norfolk, Virginia, USA.
Judith ChungDepartment of Obstetrics and Gynecology, University of California, Irvine Orange, California, USA.
Courtney D LynchDepartment of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, USA.
William A GrobmanDepartment of Obstetrics and Gynecology, Brown University, Providence, Rhode Island, USA.
Kartik K VenkateshDepartment of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, USA.

Funding

Case Western Reserve UniversityClinical and Translational Science Institute, Indiana UniversityEunice Kennedy Shriver National Institute of Child Health and Human DevelopmentInstitute for Clinical and Translational Science, University of California, IrvineThe Ohio State UniversityUniversity of PennsylvaniaUniversity of PittsburghUniversity of Utah
6 · The paper itself

Abstract

objectiveTo examine whether neighbourhood socioeconomic disadvantage, as measured by the Area Deprivation Index (ADI) in early pregnancy, was associated with severe maternal morbidity (SMM) at delivery hospitalisation.

designA prospective multi-site observational cohort.

settingA secondary analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be study (nuMoM2b) across eight United States (US) sites from 2010 to 2013. STUDY

designParticipant residential address in the first trimester was geocoded at the US census-tract level to calculate the ADI, a standardised metric of neighbourhood socioeconomic disadvantage. We used modified Poisson regression with robust error variance and adjusted for individual-level covariates: age, pre-pregnancy body mass index, chronic hypertension, and pregestational diabetes to examine the association between the ADI [modelled in quartiles from the least (quartile 1, Q1, reference) to the most (Q4) disadvantage] and SMM. Differences in the association between ADI and SMM by self-reported race and ethnicity as a social construct were evaluated with effect modification via an interaction term in the adjusted model. MAIN OUTCOMES: SMM, based on the US Centers for Disease Control and Prevention definition, and secondarily, SMM without transfusion.

resultsAmong 9588 nulliparas, 2.3% (n = 221) experienced any SMM and 0.5% (n = 48) experienced non-transfusion SMM. Individuals living in the most disadvantaged neighbourhoods (Q4) were more likely to experience SMM compared with those in the least disadvantaged neighbourhoods (Q1) (3.4% vs. 2.1%; aRR 1.73; 95% CI: 1.17, 2.58). This association was also significant for non-transfusion SMM (1.0% vs. 0.3%; aRR: 2.82; 95% CI 1.15, 6.93). Individuals who self-identified as non-Hispanic Black were more likely to experience SMM than non-Hispanic White individuals (3.9% vs. 2.1%; p < 0.001). There was no evidence of effect modification by self-reported race and ethnicity (interaction p > 0.05).

conclusionNulliparous pregnant individuals who lived in the most disadvantaged US neighbourhoods were at increased risk of experiencing SMM. Known racial and ethnic disparities in SMM may be related to adverse neighbourhood-level social determinants.

Indexed as

Neighborhood CharacteristicsPregnancy ComplicationsAdultCohort StudiesFemaleHumansPregnancyProspective StudiesResidence CharacteristicsSocioeconomic Disparities in HealthSocioeconomic FactorsUnited Statesarea deprivation indexpregnancysevere maternal morbiditysocioeconomic disadvantage

Identifiers

PMID41024747
PMCPMC12592760

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.