Disparities and Early Engagement Associated with the 18- to 36-Month High-Risk Infant Follow-Up Visit among Very Low Birthweight Infants in California - 15/09/22
, Elizabeth E. Rogers, MD 4, Tianyao Lu, MS 5, Erika Gray, BA 5, Lelis Vernon 6, 7, Heather Briscoe, MD 4, Jochen Profit, MD, MPH 5, 6, Maria A.L. Jocson, MD, MPH 8, Susan R. Hintz, MD, MS 5, 6Abstract |
Objective |
To determine follow-up rates for the high-risk infant follow-up (HRIF) visit at 18-36 months among infants with very low birthweights and identify factors associated with completion.
Study design |
We completed a retrospective cohort study using linked California Perinatal Quality of Care Collaborative neonatal intensive care unit, California Perinatal Quality of Care Collaborative California Children’s Services HRIF, and Vital Statistics Birth Cohort databases. We identified maternal, sociodemographic, neonatal, clinical, and HRIF program level factors associated with the 18- to 36-month follow-up using multivariable Poisson regression.
Results |
From 2010 to 2015, among 19 284 infants with very low birthweight expected to attend at least 1 visit at 18-36 months, 10 249 (53%) attended. On multivariable analysis, factors independently associated with attendance at an 18- to 36-month visit included estimated gestational age (relative risk [RR], 1.21; 95% CI, 1.15-1.26; <26 weeks vs ≥31 weeks), maternal education (RR, 1.09; 95% CI, 1.06-1.12; college degree or more vs high school), distance from clinic (RR, 0.92; 95% CI, 0.89-0.97; fourth quartile vs first quartile), and Black non-Hispanic race vs White race (RR, 0.88; 95% CI, 0.84-0.92). However, completion of an initial HRIF visit within the first 12 months was the factor most strongly associated with completion of an 18- to 36-month visit (RR, 6.47; 95% CI, 5.91-7.08).
Conclusions |
In a California very low birthweight cohort, maternal education, race, and distance from the clinic were associated with sustained HRIF participation, but attendance at a visit by 12 months was the most significantly associated factor. These findings highlight the importance of early engagement with all families to ensure equitable follow-through for children born preterm.
Le texte complet de cet article est disponible en PDF.Abbreviations : CCS, CPQCC, HRIF, NICU, RR
Plan
| Partially funded by a grant from the Health Resources and Services Administration (HRSA), United States of the U.S. Department of Health and Human Services (HHS), United States. The findings and conclusions in this article are those of the authors and do not necessarily represent the official views of HRSA, HHS, the California Department of Health Care Services, or the California Health and Human Services Agency. A.L. is supported by grants from the Sharon D. Lund Foundation. S.H. is supported as the Robert L. Hess Family Endowed Professor of Neonatal and Developmental Medicine at Stanford University School of Medicine, United States. J.P. is supported by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, United States (R01 HD084667-01, PI Profit). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health and Human Development or the National Institutes of Health. The funders/sponsors did not participate in the work. The authors declare no conflicts of interest. |
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| Accepted as a poster to the Pediatric Academic Societies meeting 2020 (Pediatric Academic Societies, May, 2, 2020, Poster Session, Neonatal Follow-up 3, 817). Unfortunately, due to the pandemic, the work was never presented. |
Vol 248
P. 30 - septembre 2022 Retour au numéro
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