Social Vulnerability Index and Its Association With Postpartum Care Attendance.
Academic Article
Overview
abstract
OBJECTIVE: To evaluate whether there is an association between the Centers for Disease Control and Prevention (CDC) Social Vulnerability Index (SVI) score and postpartum care attendance. METHODS: This is a retrospective cohort study of patients who delivered at 20 0/7 weeks of gestation or later at any of three hospitals within a New York City health care system from January 1, 2022, to February 1, 2024, and had at least one prenatal outpatient visit at an affiliated site before delivery. The primary outcome was at least one outpatient in-person obstetric visit within 12 weeks of delivery. The exposure was CDC-defined SVI score, with a validated technique for geocoding patient addresses used to assign overall SVI score and SVI theme scores. The SVI score was categorized into quartiles representing low to high social vulnerability. Demographic, medical, and obstetric factors were examined with univariable and multivariable logistic regression. RESULTS: Of 21,539 eligible patients, 14,026 (65.1%) attended an in-person postpartum visit within 12 weeks of delivery. In-person postpartum visit attendance was documented in 2,147 (50.3%) of those with high social vulnerability, 3,020 (64.4%) of those with medium-to-high SVI score, 4,568 (70.6%) of those with low-to-medium SVI score, and 4,191 (70.6%) of those with low SVI score. In univariable analysis, both medium-to-high SVI score and high SVI score were associated with lower odds of attending a postpartum visit (odds ratio [OR] 0.75 [95% CI, 0.70-0.82] and 0.42 [95% CI, 0.39-0.46], respectively) compared with those with low SVI score. These associations were also detected among the SVI socioeconomic, household composition, and racial and ethnic minority themes but not housing type and transportation theme. However, only high SVI score was associated with decreased odds of attending an in-person postpartum visit in multivariable models (adjusted OR 0.85 [95% CI, 0.78-0.94]). CONCLUSION: A high SVI score was associated with lower likelihood of in-person postpartum visit attendance within 12 weeks of delivery.
