The Green Room: A Podcast from Obstetrics & Gynecology February 2025: Obstetrics
Jan 21, 2025
In this discussion, Dr. Nigel Madden, a maternal fetal medicine specialist at Beth Israel Deaconess Medical Center and Harvard Medical School instructor, dives into pressing topics in obstetrics. He shares insights on the safety and efficacy of the RSV vaccine for new mothers. The conversation also highlights how area poverty significantly affects birth outcomes, illustrating the stark healthcare disparities faced by impoverished communities. Dr. Madden advocates for data-driven approaches to enhance care and reduce maternal and neonatal health disparities.
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Large Cohort And Area-Poverty Method
- The study was a retrospective cohort of over 85,000 singleton live births within one health system.
- Researchers used American Community Survey poverty percentages to create six area-poverty groups and ran regression models on seven outcomes.
Area Poverty Reflects Layered Risks
- Area poverty captures aggregated individual and environmental risks that affect birth outcomes.
- Community-level effects persist after adjusting for individual factors, implying additional neighborhood influences.
Neighborhood Poverty Mirrors Individual Risk
- Area poverty strongly aligns with individual sociodemographic risk factors like young maternal age, Black race, Hispanic ethnicity, and Medicaid coverage.
- These aggregated individual risks partly explain, but do not fully account for, area-level outcome differences.