Social disparities negatively impact neonatal follow-up clinic attendance of premature infants discharged from the neonatal intensive care unit

Swearingen, Corinne; Simpson, Pippa; Cabacungan, Erwin; Cohen, Susan

doi:10.1038/s41372-020-0659-4

Cited by 45 publications

(40 citation statements)

References 29 publications

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“…Consistent with previous research, 7,8,12,26 we found that maternal Black race was associated with decreased attendance at V2. This is an especially concerning finding given that Black children are less likely to be referred for early intervention services 27,28 and less likely to be receiving services at age 2 years, even in the presence of developmental delays.…”

Section: Discussionsupporting

confidence: 92%

Rural Residence and Factors Associated with Attendance at the Second High-Risk Infant Follow-up Clinic Visit for Very Low Birth Weight Infants in California

Fuller

Gray

et al. 2021

Am J Perinatol

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Objective This study was aimed to determine factors associated with attendance at the second high-risk infant follow-up (HRIF) visit (V2) by 20 months of corrected age after a successful first visit (V1), and the impact of rural residence on attendance rates in a statewide population of very low birth weight (VLBW; <1,500 g) infants. Study Design Data linked from the California Perinatal Quality of Care Collaborative (CPQCC) Neonatal Intensive Care Unit (NICU) database and CPQCC-California Children's Services (CCS) HRIF database. Multivariable logistic regression evaluated independent associations of sociodemographic, maternal, family, neonatal clinical, and individual HRIF program differences (factors) with successful V2 in VLBW infants born in 2010 to 2012. Results Of 7,295 eligible VLBW infants, 75% (5,475) attended V2. Sociodemographic factors independently associated with nonattendance included maternal race of Black (adjusted odds ratio [aOR] = 0.61; 95% confidence interval [CI]: 0.5–0.75), public insurance (aOR = 0.79; 95% CI: 0.69–0.91), and rural residence (aOR = 0.74; 95% CI: 0.61–0.9). Factors identified at V1that were associated with V2 attendance included attending V1 within the recommended window (aOR = 2.34; 95% CI: 1.99–2.75) and early intervention enrollment (aOR = 1.39; 95% CI: 1.12–1.61). Neonatal factors associated with attendance included birth weight ≤750 g (aOR = 1.83; 95% CI: 1.48–2.5). There were significant program differences with risk-adjusted rates ranging from 43.7 to 99.7%. Conclusion Sociodemographic disparities and HRIF program factors are associated with decreased attendance at V2 among VLBW infants. These findings highlight opportunities for quality and process improvement interventions starting in the NICU and continuing through transition to home and community to assure participation in HRIF. Key Points

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Section: Discussionsupporting

confidence: 92%

Rural Residence and Factors Associated with Attendance at the Second High-Risk Infant Follow-up Clinic Visit for Very Low Birth Weight Infants in California

Fuller

Gray

et al. 2021

Am J Perinatol

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“…Another important etiology that may explain disparities in readmissions and mortality is access to medical care. Lower attendance in post-discharge subspecialty care, including high-risk clinics dedicated to the needs of preterm infants occurs more often among Black families, compared to White families [7]. Overcoming barriers to clinic participation may include provision of transportation, conducting visits remotely, and/or coordinating home visits.…”

mentioning

confidence: 99%

Racial and ethnic disparities in preterm birth outcomes: a call to action for neonatal providers

Burris

Parker

2021

J Perinatol

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“…Disparities related to race/ethnicity, maternal age, insurance status, immigrant status, etc. may lead to differing rates of outpatient follow-up and acute care use for preterm infants [45][46][47]. Structured transition-to-home programs may decrease the disparity of certain outcomes, such as emergency department visits [48].…”

Section: Disparitiesmentioning

confidence: 99%

Influences of environmental exposures on preterm lung disease

Collaco¹,

Aoyama²,

Rice³

et al. 2021

Expert Review of Respiratory Medicine

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Introduction: Environmental factors play a critical role in the progression or resolution of chronic respiratory diseases. However, studies are limited on the impact of environmental risk factors on individuals born prematurely with lung disease after they leave the neonatal intensive care unit and are discharged into the home environment. Areas covered:In this review, we cover current knowledge of environmental exposures that impact outcomes of preterm respiratory disease, including air pollution, infections, and disparities. The limited data do suggest that certain exposures should be avoided and there are potential preventative strategies for other exposures. There is a need for additional research outside the neonatal intensive care unit that focuses on individual and community-level factors that affect long-term outcomes.Expert opinion: Preterm respiratory disease can impose a significant burden on infants, children, and young adults born prematurely, but may improve for many individuals over time. In this review, we outline the exposures that may potentially hasten, delay, or prevent resolution of lung injury in preterm children.

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Social disparities negatively impact neonatal follow-up clinic attendance of premature infants discharged from the neonatal intensive care unit

Cited by 45 publications

References 29 publications

Rural Residence and Factors Associated with Attendance at the Second High-Risk Infant Follow-up Clinic Visit for Very Low Birth Weight Infants in California

Rural Residence and Factors Associated with Attendance at the Second High-Risk Infant Follow-up Clinic Visit for Very Low Birth Weight Infants in California

Racial and ethnic disparities in preterm birth outcomes: a call to action for neonatal providers

Influences of environmental exposures on preterm lung disease

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