首页|High-Risk Neighborhoods and Neurodevelopmental Outcomes in Infants Born Preterm
High-Risk Neighborhoods and Neurodevelopmental Outcomes in Infants Born Preterm
扫码查看
点击上方二维码区域，可以放大扫码查看
原文链接
NSTL
Elsevier
Objective To study the association between neighborhood risk and moderate to severe neurodevelopmental impairment (NDI) at 22-26 months corrected age in children born at <34 weeks of gestation. We hypothesized that infants born preterm living in high-risk neighborhoods would have a greater risk of NDI and cognitive, motor, and language delays. Study design We studied a retrospective cohort of 1291 infants born preterm between 2005 and 2016, excluding infants with congenital anomalies. NDI was defined as any one of the following: a Bayley Scales of Infant and Toddler Development-III Cognitive or Motor composite score <85, bilateral blindness, bilateral hearing impairment, or moderate-severe cerebral palsy. Maternal addresses were geocoded to identify census block groups and create high-risk versus low-risk neighborhood groups. Bivariate and regression analyses were run to assess the impact of neighborhood risk on outcomes. Results Infants from high-risk (n = 538; 42%) and low-risk (n = 753; 58%) neighborhoods were compared. In bivariate analyses, the risk of NDI and cognitive, motor, and language delays was greater in high-risk neighborhoods. In adjusted regression models, the risks of NDI (OR, 1.43; 95% CI, 1.04-1.98), cognitive delay (OR, 1.62; 95% CI, 1.15-2.28), and language delay (OR, 1.58; 95% CI, 1.15-2.16) were greater in high-risk neighborhoods. Breast milk at discharge was more common in low-risk neighborhoods and was protective of NDI in regression analysis. Conclusions High neighborhood risk provides an independent contribution to preterm adverse NDI, cognitive, and language outcomes. In addition, breast milk at discharge was protective. Knowledge of neighborhood risk may inform the targeted implementation of programs for socially disadvantaged infants.
LOW-BIRTH-WEIGHTGROSS MOTOR FUNCTIONINTENSIVE-CARE-UNITBREAST-MILKNEUROCOGNITIVE OUTCOMESCHILDREN BORNAGEIMPACTLANGUAGEDISADVANTAGE
Nwanne, Ogochukwu Y.、Rogers, Michelle L.、McGowan, Elisabeth C.、Tucker, Richard、Smego, Raul、Vohr, Betty R.、Vivier, Patrick M.
NSTL
Elsevier
