(681) The Relationship between Neighborhood Food Environment and Readmissions for Postpartum Hypertension and Cardiovascular Complications

Objective: Postpartum readmissions have negative consequences on patients and the healthcare system. Some of the most frequent etiologies for postpartum readmission are hypertensive and cardiovascular-related. Few studies have assessed the effects of social factors on postpartum readmissions. We aimed to determine whether the neighborhood food environment impacts the frequency of readmission for hypertensive and cardiovascular complications.

Study Design: A regional hospital dataset was queried for cardiovascular and hypertension-related readmissions in the postpartum period using ICD 9/10 codes. We looked at readmissions within 12 weeks of delivery for hypertension and 12 months for cardiovascular complications between 2014 and 2018. Each encounter included a patient’s GEO-ID which allowed linkage to geospatial datasets. The neighborhood food environment was then assessed by measuring the density/distance to select business points-of-interest obtained from Data Axle. The Wilcoxon rank-sum test was used to compare the cohort of patients requiring readmission to those who did not. The effect size was then quantified by quantile regression estimating with 95% confidence the difference in medians.

Results: There were 443,578 deliveries in the study timeframe. Of these, 432,947 had associated Data Axle information available and were included in the study. 5,363 (1.2%) patients had a readmission for hypertension within 12 weeks. 2,165 (0.5%) patients had a cardiovascular readmission within 365 days. Patients who required hypertensive-related readmission were shown to have a significantly lower density of eating places within one kilometer (p=< 0.001). Similarly, individuals who required readmission for cardiovascular-related complications also had a lower density of eating places within one kilometer (p=< 0.002).

Conclusion: It is imperative to consider the interplay of social factors such as the neighborhood food environment on pregnancy outcomes. Differences in food density may impact patients’ ability to access healthy foods, which may relate to subsequent increased readmissions and other health consequences.