Unmet Social Needs in the Prenatal Period: Effects on Birth Outcomes and Child Health [39O

Abstract

INTRODUCTION: The impact of prenatal social needs, including food insecurity, on both perinatal and child health is not fully understood. It is clear that childhood social needs negatively impact child developmental and health outcomes. This study examines the extent to which prenatal social needs are associated with adverse pregnancy and child health outcomes. METHODS: We conducted a retrospective chart review of 268 mother-child dyads receiving prenatal and pediatric care at a large public, academically affiliated safety net medical center. All mother-child dyads who completed any pediatric clinic social need screening between October 2018 and July 2019 were included in the study. IRB approval obtained from LA-Biomed. RESULTS: Mothers who experienced prenatal food insecurity had higher odds of experiencing various social needs in the pediatric setting (odds ratio [OR] 3.57; 95% confidence interval [CI] 1.52–8.35, P=.003). Mothers experiencing prenatal food insecurity had 4.45 higher odds of having a child that was born premature at fewer than 36 weeks gestation (95% CI 1.33–14.91, P=.016). Mothers who had prenatal food insecurity also had children with higher counts of inpatient visits (incidence rate ratio [IRR] 2.49, 95% CI 1.07–5.82, P=.035) and missed immunizations (IRR 1.25, 95% CI 0.15–2.35, P=.026) in the first 6 months of life. CONCLUSION: Prenatal social needs, especially food insecurity, were found to be associated with adverse perinatal and pediatric outcomes, including prematurity, inpatient hospitalizations, and missed vaccinations. Social needs in the prenatal period may offer opportunities to intervene and reduce their impact on both perinatal and child health as well as family well-being.