Severity of homelessness and adverse birth outcomes

Predictors and the prevalence of adverse birth outcomes among 237 homeless women interviewed at 78 shelters and meal programs in Los Angeles in 1997 w ere assessed. It was hypothesized that they would report worse outcomes tha n national norms, that African Americans would report the worst outcomes be cause of their greater risk in the general population, and that homelessnes s severity would independently predict poorer outcomes beyond its associati on with other adverse conditions. Other predictors included reproductive hi story, behavioral and health-related variables, psychological trauma and di stress, ethnicity, and income. African Americans and Hispanics reported wor se outcomes than are found nationally, and African Americans reported the w orst outcomes. In a predictive structural equation model, severity of homel essness significantly predicted low birth weight and preterm births beyond its relationship with prenatal care and other risk factors.