Assessing Differences in Adverse Maternal Outcomes by Zip Code and Social Vulnerability in a Low-Risk Obstetric Cohort

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Presenter Information(s)

Gabriella Mayne

Abstract or Description

Maternal health is characterized by substantial disparities observed across spatial boundaries. Anti-racist clinical initiatives seek to identify and ameliorate disparities through evidence-based quality care improvements. Assessing differences in patient outcomes by zip code may inform targeted initiatives in vulnerable populations. We examined associations between adverse maternal outcomes (AMO) and patient zip code in a low-risk obstetric cohort from a Denver-metro Colorado hospital (N=7,691). AMO is a composite variable including severe maternal morbidity and mortality, postpartum hemorrhage, intra-amniotic infection, obstetric anal sphincter injury, and unplanned cesarean section. We hypothesized zip codes with higher percentage AMO would associate with higher social vulnerability, comprised of indicators such as per-capita income, percent without health insurance, poverty, and unemployment. We included patients 18-50 years old with a live, singleton, full term fetus. We excluded patients with baseline risks that precluded low-risk management. We selected zip codes populated by thirty or more participants and compared the first and third tertiles for percentage AMO by zip code-level social vulnerability indicators. We used Mann-Whitney to compare tertiles and visualized spatial patterns of AMO and social vulnerability using Geographic Information Systems. I will present preliminary results.

Mentor

Ivan Ramirez