Evidence map›Paper›PMID 41069214›Full record

ArticleBJOG : an international journal of obstetrics and gynaecology2025

Maternal and Infant Outcomes for Women Experiencing Homelessness Before and During Pregnancy: A Retrospective Cohort Study.

Dorothea Geddes-Barton, Raph Goldacre, Serena Luchenski, Chelsea Daniels, Rhiannon D Arcy, Marian Knight, Nicola Vousden

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Article 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. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Dorothea Geddes-BartonNational Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Raph GoldacreApplied Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Serena LuchenskiCollaborative Centre for Inclusion Health, Institute of Epidemiology and Healthcare, University College London, London, UK.
Chelsea DanielsDepartment of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
Rhiannon D ArcyNational Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Marian KnightNational Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0002-1984-4575
Nicola VousdenNational Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0001-5216-8268

Funding

Academy of Medical SciencesNational Institute for Health and Care Research
6 · The paper itself

Abstract

objectiveTo explore whether women experiencing homelessness during pregnancy have higher risks of adverse pregnancy outcomes compared to housed women.

designPopulation-based retrospective cohort study using national electronic hospital records.

settingMaternity services across English NHS hospitals. POPULATION: Women giving birth at gestational age ≥ 24 weeks from January 1, 2013 to March 31, 2023.

methodsData were obtained from the English National Hospital Episode Statistics Admitted Patient Care database. Poisson regression models compared outcomes for women identified as homeless to housed women, adjusting for age, parity, ethnicity, year and pre-existing medical conditions.

main outcome measuresSevere maternal morbidity (SMM), preterm birth (< 37 and < 34 weeks), and low birth weight (< 2500 g).

resultsAmong 3 349 601 women giving birth, 3301 (0.1%) experienced homelessness. Rates and adjusted risk ratios (aRR) comparing homeless to housed women were: SMM 2.5% versus 1.6% (aRR 1.28, 95% CI 1.02-1.59); preterm birth 11.8% versus 5.9% (aRR 1.88, 95% CI 1.69-2.08); and small for gestational age 9.0% versus 4.8% (aRR 1.56, 95% CI 1.38-1.76). Stratified by ethnicity, White homeless women had the highest risk for preterm birth and small for gestational age, while Asian homeless women showed the greatest risk for SMM, compared to White housed women.

conclusionsHomelessness recorded during pregnancy or at birth is associated with poorer maternal and infant outcomes. Interventions focusing on housing stability are key. Future research should explore housing dynamics beyond homelessness, including frequent moves and overcrowding, requiring detailed perinatal housing data.

Indexed as

Ill-Housed PersonsPregnancy ComplicationsPregnancy OutcomePremature BirthAdultEnglandFemaleHumansInfant, Low Birth WeightInfant, NewbornInfant, Small for Gestational AgePregnancyRetrospective StudiesRisk FactorsYoung Adulthomelessnessinclusion healthmaternal morbidityroutine data

Identifiers

PMID41069214
PMCPMC12592753

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