Association of Eviction With Adverse Birth Outcomes Among Women in Georgia, 2000 to 2016

IMPORTANCE: More than 2 million families face eviction annually, a number likely to increase due to the coronavirus disease 2019 pandemic. The association of eviction with newborns’ health remains to be examined. OBJECTIVE: To determine the association of eviction actions during pregnancy with birth outcomes. DESIGN: This case-control study compared birth outcomes of infants whose mothers were evicted during gestation with those whose mothers were evicted at other times. Participants included infants born to mothers who were evicted in Georgia from January 1, 2000, to December 31, 2016. Data were analyzed from March 1 to October 4, 2020. EXPOSURES: Eviction actions occurring during gestation. MAIN OUTCOMES AND MEASURES: Five metrics of neonatal health included birth weight (in grams), gestational age (in weeks), and dichotomized outcomes for low birth weight (LBW) (<2500 g), prematurity (gestational age <37.0 weeks), and infant death. RESULTS: A total of 88 862 births to 45 122 mothers (mean [SD] age, 26.26 [5.76] years) who experienced 99 517 evictions were identified during the study period, including 10 135 births to women who had an eviction action during pregnancy and 78 727 births to mothers who had experienced an eviction action when not pregnant. Compared with mothers who experienced eviction actions at other times, eviction during pregnancy was associated with lower infant birth weight (difference, −26.88 [95% CI, −39.53 to 14.24] g) and gestational age (difference, −0.09 [95% CI, −0.16 to −0.03] weeks), increased rates of LBW (0.88 [95% CI, 0.23-1.54] percentage points) and prematurity (1.14 [95% CI, 0.21-2.06] percentage points), and a nonsignificant increase in mortality (1.85 [95% CI, −0.19 to 3.89] per 1000 births). The association of eviction with birth weight was strongest in the second and third trimesters of pregnancy, with birth weight reductions of 34.74 (95% CI, −57.51 to −11.97) and 35.80 (95% CI, −52.91 to −18.69) g, respectively. CONCLUSIONS AND RELEVANCE: These findings suggest that eviction actions during pregnancy are associated with adverse birth outcomes, which have been shown to have lifelong and multigenerational consequences. Ensuring housing, social, and medical assistance to pregnant women at risk for eviction may improve infant health.