New index could help measure risk for preterm birth
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Key takeaways:
- A high score on the Maternal Vulnerability Index was associated with preterm birth.
- The index takes community conditions into consideration as to how they could affect a pregnancy.
A new index that takes neighborhood and community conditions into consideration could be a useful measure for identifying preterm birth risk, a study published in JAMA Network Open found.
“We're looking at outcomes at the county level or exposures at the county level,” Sara C. Handley, MD, MSCE, an attending neonatologist at The Children’s Hospital of Philadelphia and instructor of pediatrics at the University of Pennsylvania Perelman School of Medicine, told Healio.
“So, what was the maternal vulnerability in each U.S. county, and then what were the rates of preterm birth in those counties? We looked at different types of vulnerabilities that were developed through the Maternal Vulnerability Index, and also the type of severity of preterm birth,” Handley explained.
The Maternal Vulnerability Index (MVI) is a county-level index that quantifies maternal vulnerability to adverse health outcomes associated with preterm births through 43 indicators that reflect physical, social and health care landscapes. It is organized into six themes: reproductive health care, physical health, mental health and substance abuse, general health care, socioeconomic determinants and physical environment.
Handley and colleagues used the index in a cohort study of birth certificate data from 3,659,099 infants born at 22 to 44 plus 6/7 weeks of gestation in 2018.
Of them, 298,847 were preterm, for which the MVI was higher across all measures. A very high MVI was associated with increased preterm birth in unadjusted (OR = 1.50; 95% CI, 1.45-1.56) and adjusted (OR = 1.07; 95% CI, 1.01-1.13) analyses.
Handley said she is interested in how the MVI “may or may not change over time,” and what implications its results could have for health.
“I know that there's increasing screening that's being done both in hospitals and clinics asking about socioeconomic determinants in terms of families, resources and other barriers or stressors, to accessing health and education and food,” Handley said. “I think it's a reminder that these things are important, and we need to ask our patients and their families about them so we can try and think about how and which resources may be helpful.”
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