Citation

Nwanne OY, Rogers ML, McGowan EC, Tucker R, Smego R, Vivier PM, Vohr B. J. Pediatr. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/j.jpeds.2022.01.042

PMID

35120984

Abstract

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, cognitive, motor, and language delay. STUDY DESIGN: We studied a retrospective cohort of 1291 infants born preterm from 2005-2016, 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 versus low neighborhood risk 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, cognitive, motor, and language delay was greater in high-risk neighborhoods. In adjusted regression models, the risk of NDI (OR:1.43, CI:1.04, 1.98), cognitive (OR:1.62, CI:1.15, 2.28), and language (OR:1.58, CI:1.15, 2.16) delay was greater in high-risk neighborhoods. Breastmilk at discharge was more common in low-risk neighborhoods and was protective of NDI in regression analysis.

CONCLUSION: 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.

Language: en

Keywords

Geocoding; Cognitive delay; Language delay; Motor delay; Neighborhood risk; Neurodevelopment; Neurodevelopmental impairment; Prematurity