747 Residence change during pregnancy and adverse pregnancy outcomes

Abstract

Moving during pregnancy is a potential source of stress and disrupted access to care, and has been associated with low birth weight and preterm birth. Our study examined associations between residence change and adverse pregnancy outcomes. We conducted a retrospective analysis of a prospective cohort of gravidae delivering singleton, non-anomalous infants from 2011–2020. Data were collected from an institutional perinatal database comprised of two hospitals in a large US urban center. Residence change was defined as at least one change in home zip code during pregnancy. Univariate analyses were performed using Chi-square tests. Logistic regression quantified associations between residence change and adverse pregnancy outcomes: preterm birth, hypertensive disease of pregnancy, small for gestational age, and large for gestational age (LGA). Adjusted models included maternal age, gravidity, race, ethnicity, education, household income, pre-pregnancy obesity, and smoking. Of 31,476 women meeting inclusion criteria, 2,663 (8.5%) reported at least one residence change in pregnancy. Women who moved were less likely to be Hispanic/Latino, and more likely to be Black, to have higher educational attainment and household income, and to have adequate prenatal care (Figure). Women tended to move to neighborhoods with lower social deprivation scores. In unadjusted regression models, women who moved were less likely to be diagnosed with hypertensive disease of pregnancy (OR 0.89, 95% CI 0.79–0.99) and less likely to have a LGA infant (OR 0.83, 95% CI 0.70–0.97). In adjusted regression models, residence change was not associated with any adverse pregnancy outcomes (Table). In contrast to prior work, we found that residence change during pregnancy was not associated with adverse pregnancy outcomes. Characteristics of our cohort indicate that women with more resources are more likely to move in pregnancy, suggesting upward mobility. Further work should examine how residence changes motivated by positive versus negative factors may have differing implications during pregnancy.View Large Image Figure ViewerDownload Hi-res image Download (PPT)