Abstract
The social vulnerability index (SVI) is a place-based index used to stratify community risk. We evaluated the impact of SVI on pregnancy and infant outcomes in patients with surgically treatable congenital anomalies.This is a retrospective study of pregnant patients and infant dyads diagnosed from 2014 to 2022 with congenital anomalies amenable to surgical treatment. Dyads were grouped into SVI quartiles. Primary outcomes were infant morbidity and mortality, and secondary outcomes included prenatal care services, pregnancy course characteristics, and pregnant person co-morbidities. The area deprivation index and child opportunity index were also collected. Bivariate comparisons of patient characteristics and unadjusted odds ratios for death or morbidity stratified by SVI quartile were performed.Two hundred and ninety-five dyads met the inclusion criteria. Ten point two percent had low SVI, 23.7% low-medium, 35.3% medium-high, and 30.9% high. The only prenatal care service associated with SVI quartile was fetal MRI (p = 0.038), but no directional trend was observed. Infant diagnoses included 11.5% congenital diaphragmatic hernia, 27.5% gastroschisis, 18.6% intestinal atresia, 9.2% lower urinary tract obstruction, 20.3% myelomeningocele, 9.2% omphalocele, 0.3% sacrococcygeal teratoma, 8.5% tracheoesophageal fistula. The odds ratio of poor infant outcomes by SVI quartile showed a nonsignificant elevated odds ratio in the highest quartile SVI (low-medium SVI OR: 0.66 [95% CI: 0.14, 2.35], medium-high SVI OR: 0.78 [95% CI: 0.17, 2.63], and high SVI OR: 1.57 [95% CI: 0.32, 6.4]).SVI quartile was not associated with infant outcomes in patients with surgically treatable congenital anomalies. Future studies should examine the impact of SVI or other indices of social vulnerability on perinatal and long-term postnatal outcomes in these high-risk patients. · Healthcare inequities warrant exploration in congenital surgical pathologies.. · Explored SVI quartile association with infant outcomes.. · Primary outcomes were not associated with SVI quartile.. · Nonsignificantly higher odds of poor outcome in patients with high SVI quartile..