Original ArticlesInfluence of Socioeconomic Context on the Rehospitalization Rates of Infants Born Preterm
Section snippets
Methods
This cohort study analyzed prospectively acquired perinatal and infant follow-up data collected in the western part of the Provence-Alpes-Côte-d'Azur region (West-PACA) by the medical network known as the Naître et Devenir-Mediterranée Network (the NaDeM Network). The NaDeM Network is registered with the French data protection authority for clinical research (Commission Nationale de l'Informatique et des Libertés or CNIL, No. 1460797). The study was approved by the local institutional ethics
Results
During the study period, 3719 preterm infants with GA of <32 + 6 weeks were born in the West-PACA area and survived to the neonatal period; 3140 infants were eligible after exclusion of infants whose parents did not reside in the West-PACA area (n = 579). Exclusions from the study (refusal of consent, congenital anomalies, inadequate residential address, family moved out of the area, lost to follow-up, and sudden infant death syndrome) are shown in Figure 1 (available at www.jpeds.com). The
Discussion
This study showed that children who were born preterm and lived in an area of socioeconomic deprivation had a significantly higher risk of being rehospitalized within the first year of life than those who lived in less socioeconomically deprived areas. This association was also observed for all causes of rehospitalization. Although this vulnerable population of children received routine follow-up by a large medical network (NaDeM) in France, where there is extensive welfare and coverage for
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Chronic Neonatal Respiratory Disorders
2023, Avery's Diseases of the NewbornHigh Healthcare Use at Age 5 Years in a European Cohort of Children Born Very Preterm
2022, Journal of PediatricsNeighborhood Disadvantage and Early Respiratory Outcomes in Very Preterm Infants with Bronchopulmonary Dysplasia
2021, Journal of PediatricsCitation Excerpt :BPD was defined as the need for oxygen or ventilator support (including high-flow nasal cannula therapy) at 36 weeks postmenstrual age. Infants with valid family addresses, those with no severe congenital anomalies, and those who received follow-up care from a regional medical network based in the west of the Provence–Alpes–Côte d’Azur (PACA) region, the Naître et Devenir−Mediterranée (NaDeM) Network, up to 1 year after discharge from the neonatal unit were eligible for inclusion.17 Among infants who were born and living in the region, approximately 82% received care from the network for up to age 1 year during the study period.
Neighborhood Inequality and Emergency Department Use in Neonatal Intensive Care Unit Graduates
2020, Journal of PediatricsCitation Excerpt :The strengths of this work include a longitudinal study of NICU graduates using geocoding to examine the impact of neighborhood risk on ED use, analyses that adjusted for environmental, psychosocial, and medical risk factors, and findings that justify using neighborhood risk to impact policy and protocols to improve outcomes for high-risk infants. We acknowledge that living in a high-risk neighborhood in Rhode Island and Southeastern Massachusetts may differ with living in a high-risk neighborhood in other parts of the country; however, given what is measured with the index (high prevalence of sociodemographic and housing characteristics known to be associated with poor health outcomes), we would expect the overall findings to be generalizable to other areas of the country.8,14-22,27 Limitations include the characteristics of our cohort; 100% of the families received enhanced transition home services which may have led to an underestimate of neighborhood impact and ED use rates.
The authors declare no conflicts of interest.