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Updated: Mar 21, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Parent Language: A Predictor for Neurodevelopmental Follow-up Care Among Infants With Very Low Birth Weight
Monica Eneriz-Wiemer1, Olga Saynina2, Vandana Sundaram3
1Department of Pediatrics, Palo Alto Medical Foundation, Palo Alto, Calif; Division of General Pediatrics, Stanford University School of Medicine, Los Gatos, Calif.
Insights
Infants of parents with non-English primary languages received more recommended outpatient care, including influenza vaccination and preventive visits. However, overall follow-up care rates for all infants remain below national guidelines.
Area of Science:
- Neonatal care
- Pediatric health outcomes
- Health disparities
Background:
- Preterm and very low birth weight infants are at risk for neurodevelopmental delays.
- Parents speaking non-English primary languages (NEPL) report poorer healthcare communication and fewer specialty referrals for their children.
- Timely neurodevelopmental monitoring and referrals are crucial for these infants.
Purpose of the Study:
- To determine if infants of NEPL parents receive recommended outpatient follow-up care for neurodevelopment.
- To compare the follow-up care received by infants of NEPL parents versus infants of English-speaking parents.
Main Methods:
- Linked California Children's Services claims with California Perinatal Quality Care Collaborative data for publicly insured infants (<1500g birth weight or ≤32 weeks gestational age).
- Assessed outcomes including preventive visits, ophthalmology visits, influenza vaccination, and palivizumab receipt.
- Adjusted analyses for medical severity and sociodemographic factors.
Main Results:
- Infants of NEPL parents had higher odds of receiving influenza vaccination (38% increase) and completed more preventive visits (8% increase).
- No significant differences were found in hospital length of stay or readmissions between groups.
- A total of 433 infants (28%) had parents with NEPL.
Conclusions:
- Infants of NEPL parents received more aspects of recommended outpatient follow-up care compared to infants of English speakers.
- All infants, regardless of parental language, received follow-up care at rates lower than recommended by national guidelines.
- Further research is needed to identify and address the reasons for these care gaps.
Objective:
Preterm/very low birth weight infants may suffer neurodevelopmental delays. Pediatricians should monitor neurodevelopment and pursue timely referrals. Yet parents who speak non-English primary languages (NEPL) report worse health care communication and fewer appropriate specialty referrals for their children. We sought to determine whether infants of NEPL parents receive recommended outpatient follow-up care for neurodevelopment. We hypothesized that these infants received less care than infants of English speakers.
Methods:
We linked paid claims from California Children's Services to clinical data from California Perinatal Quality Care Collaborative (58% linkage rate, 1541 subjects) for publicly insured infants with birth weight <1500 g or gestational age ≤32 weeks. Our primary outcomes were completion of 1) preventive visits and 2) ophthalmology visits; and receipt of 3) influenza vaccination and 4) palivizumab. To compare group differences, we also assessed 5) hospital length of stay and 6) readmissions. Analyses were adjusted for medical severity and sociodemographic characteristics.
Results:
A total of 433 infants (28%) had NEPL parents. Infants of NEPL parents had 38% higher odds of receiving influenza vaccination (95% confidence interval 9-75, P = .008) and completed 8% more preventive visits (95% confidence interval 1-64, P = .019) than infants of English speakers. Infants of NEPL parents did not have longer lengths of stay or more readmissions.
Conclusions:
Infants of NEPL parents were more likely than infants of English speakers to receive some aspects of recommended outpatient follow-up care. Regardless of language, all infants received far lower rates of follow-up care than recommended by national guidelines. Future study should address the causes of these gaps.
