Association Between the Social Vulnerability Index and Adverse Pregnancy Outcomes

( Obstet Gynecol . 2025;145:503-510. doi: 10.1097/AOG.0000000000005890.) In the United States, racial disparities in maternal care are a significant problem, with a large body of evidence showing that non-Hispanic black women have a maternal mortality rate 3.5 times higher than white women and a stillbirth rate more than twice as high. Studies have shown that some differences can be explained by disparities in socioeconomic status, stress, and structural racism, and some of this gap remains unexplained. The Social Vulnerability Index (SVI) was developed by the Centers for Disease Control and Prevention (CDC) to assess community resilience to stressors such as natural disasters and health crises. Previous research has shown some correlation between the SVI and pregnancy outcomes, although robust evidence is lacking. This study was designed to evaluate the association between social vulnerability as measured by the SVI and severe pregnancy outcomes, including maternal mortality, stillbirth, and preterm birth.