Associations between health-related social needs and postpartum linkage to care

Introduction: Ongoing care after pregnancy is recommended. Health-related social needs are recognized barriers to care, yet their pregnancy-related prevalence and associations with care are unknown. Researchers sought to assess (1) the prevalence of health-related social needs during pregnancy-based care, and (2) their associations with ongoing care after pregnancy. 

Methods: Electronic health record data were analyzed for individuals with prenatal care and delivery (2018–2021) at an urban safety-net hospital, with routine screening for health-related social needs multiple times during pregnancy through 6 weeks postpartum. Health-related social needs were summarized as screened negative, screened positive, or not screened. Linkage to ongoing care was defined as a completed non-urgent visit separate from pregnancy-based care, >6 weeks through 1 year postpartum. Data were collected in 2022 and analyzed in 2023–2024. 

Results: Of 4,941 individuals, 53% identified as Black non-Hispanic and 21% as Hispanic, 68% were publicly insured, and 93% completed ≥1 health-related social needs screening. Nearly 1 in 4 screened positive for health-related social needs, and 53% linked to ongoing care. Compared with those who screened negative for health-related social needs (n=3,491), linkage to ongoing care was similar among those who screened positive (n=1,079; adjusted risk ratio, aRR=1.04, 95% CI=0.98, 1.10) and lower among those not screened (n=371; aRR=0.77, 95% CI=0.68, 0.86). 

Conclusions: Researchers identified a 24% prevalence of pregnancy-related health-related social needs and 53% subsequent linkage to ongoing care. Compared with screening negative for health-related social needs, screening positive was not associated with linkage to care, while being not screened was associated with a 20% lower likelihood of linkage to ongoing care.