Area Deprivation Index and Its Association With Adverse Neonatal Outcomes [ID 1136]

INTRODUCTION: Neighborhoods of deprivation have been associated with poorer health outcomes and prognosis of chronic conditions like diabetes and cholesterol. This study evaluates whether neighborhood deprivation, measured by Area Deprivation Index (ADI), is associated with adverse maternal obstetric and neonatal outcomes. METHODS: We obtained deidentified singleton birth data in Long Island Suffolk County in 2022 using New York Statewide Perinatal Data System (SPDS). We categorized patients based on deprivation factors into quartiles. Primary outcomes were composite severe maternal morbidity (SMM) (intensive care unit [ICU] admission, unplanned hysterectomy or reoperation, eclampsia, blood transfusion) and ICU admission. Secondary outcomes included neonatal outcome and components of SMM. RESULTS: Out of 8,920 singleton live births, 11.09% (n=989) were in the first ADI quartile, 23.25% (n=2,074) in second, 38.92% (n=3,472) in third, and 26.74% (n=2,385) in fourth. Fourth-quartile patients were more likely to be African American, have a lower education level, or have Medicaid. A total of 449 patients experienced pregnancy-associated hypertension and 977 experienced gestational diabetes. There was no significant difference between ADI groups for composite SMM, ICU admission, maternal transfusion, unplanned hysterectomy, and unplanned reoperation. ADI Group 4 had a significant increase in neonatal ICU (NICU) admission (adjusted odds ratio [aOR] 1.23; 95% CI, 1.01–1.49) and APGAR scores lower than 7 (aOR 1.42; 95% CI, 1.03–1.94). CONCLUSIONS/IMPLICATIONS: Using a standardized birth certificate database, our observational study showed an association between ADI and NICU admission and low APGAR scores. Highlighting the socioeconomic burden on maternal and neonatal outcomes gives opportunity for larger studies and future policies to advance population health and equity.