Mothers at the Margins: The Impact of Homelessness in Pregnancy in Saskatoon, Saskatchewan

Background: Homelessness is a major social determinant of health and is associated with increased risk of adverse maternal/neonatal outcomes. Localized data on the pregnant population remains limited. The purpose of this study is to evaluate admissions and health outcomes for unhoused pregnant patients at Jim Pattison Children’s Hospital (JPCH).

Methods: A retrospective chart review was conducted for unhoused pregnant patients admitted to the Prenatal Unit at JPCH between January 2021 and December 2024. We collected rates of prenatal and intrapartum complications, neonatal outcomes, and hospital length of stay.

Results: Over time, we recorded an increase in the number of annual admissions (36 vs. 71; p < 0.01) and hospital days (309 vs. 934; p < 0.01). Infections such as HIV, syphilis and urinary tract all showed significant increases. Pregnancy complications such as GDM and anemia were both significantly increased. Contributing social stressors like mental illness and IPV increased. There were increasing risks of postpartum hemorrhage and transfusion. There were more preterm births over the years, but rates of low birth weight remained stable.

Discussion: Our findings highlight increased admissions as well as maternal/neonatal morbidity among unhoused prenatal patients over this period. Housing focused interventions could improve outcomes.