(618) Unequal Access, Unequal Outcomes: Food Deserts and Preterm Birth Rates

Social disparities are known contributors to preterm birth (PTB). Food deserts (FD), regions with limited access to nutrition/affordable food, reflect broader social, physical and emotional inequities that may adversely impact maternal and neonatal outcomes. Hence, we sought to assess the relationship between living in a FD and PTB.


Study Design:

Using our institutional obstetric database, we performed a retrospective cohort study of all deliveries with documented zip-code and clinical/demographic data. FD status was assigned by zip-code of primary residence according to the U.S. Department of Agriculture (USDA) definitions. PTB was defined as delivery < 37 weeks of gestational age (GA). Kruskal-Wallis and Chi-square tests were performed to compare continuous and categorical variables, respectively. A Poisson regression, adjusted for maternal age, race, and body mass index, was used to estimate incidence risk ratios (IRR).


Results:

Among N=20,925 pregnancies, 7,107 (34.0%) lived in a FD.  Mean GA at delivery was lower in the FD group vs those not in a FD (37.9±2.8 vs 38.2 ±2.7, p< 0.01). 14.6% (n=3,080) of the cohort experienced a PTB. Those in a FD had significantly higher rates of PTB (15.3% vs 14.2%, p=0.026) and lower neonatal birthweight (3050±621g vs 3110±617g, p< 0.001). However, there was no difference in mode of delivery by FD status (Table 1). Our data noted those who live in an FD have a 1.1-fold higher risk of experiencing a PTB (IRR 1.13, 95% CI 1.02-1.24, p< 0.01).


Conclusion:

Our data innovatively demonstrate the need to understand the impacts of living in an FD on pregnancy outcomes including PTB. These findings highlight the need to consider geographic and nutritional access factors when designing strategies to reduce PTB.