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CME Credit Offered
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Abstract Award
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Poster Session 3

(934) Association between Stillbirth and the Social Vulnerability Index.

Friday, January 31, 2025
10:30 AM – 12:30 PM  

    Submitting Author(s)

  • Tetsuya Kawakita, MD, MS

    Associate Professor
    Macon & Joan Brock Virginia Health Sciences Eastern Virginia Medical School at Old Dominion University
    Norfolk, VA, United States

    • Coauthor(s)

  • AH

    Ann Harper, MPH

    Sentara Health Research Center
    Norfolk, Virginia, United States

  • JB

    John Brush, MD

    Sentara Health Research Center
    Norfolk, Virginia, United States

    • Presenting Author(s)

  • Misa Hayasaka, MD (she/her/hers)

    Department of Obstetrics and Gynecology, Macon and Joan Brock Virginia Health Sciences at ODU
    Norfolk, Virginia, United States

    • Coauthor(s)

  • George R. Saade, MD (he/him/his)

    Professor and Chair, Associate Dean for Women's Health Obstetrics and Gynecology
    Macon & Joan Brock Virginia Health Sciences Eastern Virginia Medical School at Old Dominion University
    Norfolk, Virginia, United States

Objective:

To examine the association between stillbirth and the social vulnerability index using electronic data from a large health system.

Study Design:

This was a retrospective cohort study of pregnant individuals aged 18-50 who delivered singleton fetuses at any of 6 hospitals within our healthcare system from 2015 to 2022 and were 20 weeks or greater. We excluded pregnancies with known major fetal anomalies or chromosomal abnormalities and intrapartum stillbirth. Individuals with their unavailable addresses were also excluded. Stillbirth was defined as the birth of a fetus without signs of life at 20 weeks’ gestation or greater. The social vulnerability index (SVI) was obtained based on the census tract that pregnant individuals lived in. The overall SVI and the four domains of SVI (Socioeconomic status, household characteristics, racial and ethnic minority status, and housing type and transportation) were compared between stillbirths and live births. Multivariable logistic regression was used to calculate adjusted odds ratios (aOR) with 95% confidence intervals (95%CI), adjusting for confounders (1st quartile as referent).

Results:

Of 61,323 pregnancies, 603 (1.0%) had stillbirths and 60720 (99.0%) had live births. The distribution of the SVI in our region is presented in Figure 1. Compared to live births, stillbirths were associated with increased odds of higher overall SVI quartiles (3rd quartile aOR 1.54, 95%CI 1.22-1.96; 4th quartile aOR 1.45, 95%CI 1.13-1.87; Table 1). In the socioeconomic status domain, stillbirths were associated with increased odds of 3rd quartile SVI (but not 4th quartile). Household characteristics status domain SVI was not associated with increased odds of stillbirth. In the racial and ethnic minority status domain and housing type and transportation domain, stillbirth was associated with 4th quartile SVI.

Conclusion:

The overall SVI and the socioeconomic status, racial and ethnic minority status, and housing type and transportation SVI domains are significantly associated with increased odds of stillbirth.