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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

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High-Risk Neighborhoods and Neurodevelopmental Outcomes in Infants Born Preterm

Ogochukwu Y Nwanne1, Michelle L Rogers2, Elisabeth C McGowan1

  • 1Division of Neonatal Medicine, Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI; Department of Pediatrics, Women and Infants Hospital, Providence, RI.

The Journal of Pediatrics
|February 5, 2022
PubMed

Insights

Infants born preterm in high-risk neighborhoods face greater neurodevelopmental impairment (NDI) risks. Breast milk at discharge showed a protective effect against NDI, suggesting targeted interventions for vulnerable populations.

Area of Science:

  • Pediatric neurodevelopment
  • Environmental influences on child health
  • Public health and epidemiology

Background:

  • Preterm infants are at high risk for neurodevelopmental impairment (NDI).
  • Socioeconomic factors and neighborhood characteristics may influence NDI risk.
  • Understanding these associations is crucial for early intervention strategies.

Purpose of the Study:

  • To investigate the association between neighborhood risk and moderate to severe NDI in preterm infants.
  • To determine if living in high-risk neighborhoods increases the risk of NDI and developmental delays.
  • To explore the potential protective role of breast milk at discharge.

Main Methods:

  • Retrospective cohort study of 1291 preterm infants (<34 weeks gestation) born between 2005-2016.
  • Neurodevelopmental impairment (NDI) defined by specific cognitive, motor, sensory, and neurological criteria.
  • Maternal addresses were geocoded to classify neighborhoods as high-risk or low-risk; statistical analyses included bivariate and adjusted regression models.

Main Results:

  • Infants from high-risk neighborhoods had a significantly greater risk of NDI (OR 1.43), cognitive delay (OR 1.62), and language delay (OR 1.58).
  • Breast milk at discharge was more common in low-risk neighborhoods and demonstrated a protective effect against NDI.
  • Neighborhood risk independently contributed to adverse neurodevelopmental outcomes in preterm infants.

Conclusions:

  • High neighborhood risk is an independent factor associated with adverse neurodevelopmental outcomes in preterm infants.
  • Targeted interventions informed by neighborhood risk assessment may benefit socially disadvantaged preterm infants.
  • Breast milk at discharge is a protective factor for neurodevelopmental impairment in this population.
Abstract

Keywords:
cognitive delaygeocodinglanguage delaymotor delayneighborhood riskneurodevelopmentneurodevelopmental impairmentprematurity

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