Atkins Kristi L, Duvall Susanne W, Dolata Jill K, Blasco Patricia M, Saxton Sage N
School of Medicine, Institute on Development & Disability, Oregon Health and Science University, 707 SW Gaines St., Portland, OR, 97239, USA.
The Research Institute, Western Oregon University, 345 N. Monmouth Ave., Monmouth, OR, 97361, USA.
Matern Child Health J. 2017 Feb;21(2):290-296. doi: 10.1007/s10995-016-2113-y.
Objectives To investigate enrollment patterns in Part C Early Intervention (EI) for low birth weight (LBW) infants (≤2500 g). A secondary aim is to characterize LBW infants that are not enrolled in EI, but would qualify by meeting criteria for a condition associated with a "high-probability" for developmental delays (i.e., Intraventricular Hemorrhage grade III or higher, Apgar score of ≤5 at 5 min, and/or birth weight of ≤1200 g). Methods Data were gathered from 165 LBW infants participating in a high-risk infant follow-up program. Developmental assessment was completed. Basic demographic information and data regarding enrollment in EI were collected via parent questionnaire. Medical variables were extracted from each infant's electronic medical record. Results 71.5 % of LBW infants were not enrolled in EI. Factors influencing probability of EI enrollment included birth weight, gestational age, developmental test scores, and insurance status. Of the 107 infants living in Oregon who were not enrolled in EI, 42.1 % would qualify for services due to an early medical condition identified in Oregon as a condition associated with a "high-probability" for developmental delays. Conclusions Less than one third of LBW infants were enrolled in EI by their first visit to a high-risk infant follow-up program. Those infants demonstrating developmental delays and public insurance were more likely to be enrolled. The majority of infants who have readily identifiable medical risk factors that qualify them for EI were not enrolled. This study was limited by the constraints implicated by using a clinical sample.
调查低出生体重(≤2500克)婴儿参加C部分早期干预(EI)的登记模式。次要目的是对未参加EI但符合与发育迟缓“高概率”相关疾病标准(即III级或更高等级的脑室内出血、5分钟时阿氏评分≤5和/或出生体重≤1200克)的低出生体重婴儿进行特征描述。方法:收集了165名参加高危婴儿随访项目的低出生体重婴儿的数据。完成了发育评估。通过家长问卷收集了基本人口统计学信息和关于EI登记的数据。从每个婴儿的电子病历中提取医疗变量。结果:71.5%的低出生体重婴儿未参加EI。影响EI登记概率的因素包括出生体重、胎龄、发育测试分数和保险状况。在俄勒冈州未参加EI的107名婴儿中,42.1%因俄勒冈州确定的一种与发育迟缓“高概率”相关的早期疾病而符合服务条件。结论:在首次就诊高危婴儿随访项目时,不到三分之一的低出生体重婴儿参加了EI。那些表现出发育迟缓且有公共保险的婴儿更有可能被登记。大多数有易于识别的医疗风险因素而符合EI条件的婴儿未被登记。本研究受限于使用临床样本所带来的限制。