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社会差异对新生儿重症监护病房出院的早产儿的新生儿随访门诊出勤率产生负面影响。

Social disparities negatively impact neonatal follow-up clinic attendance of premature infants discharged from the neonatal intensive care unit.

作者信息

Swearingen Corinne, Simpson Pippa, Cabacungan Erwin, Cohen Susan

机构信息

Medical College of Wisconsin Affiliated Hospitals, Milwaukee, WI, USA.

Division of Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, WI, USA.

出版信息

J Perinatol. 2020 May;40(5):790-797. doi: 10.1038/s41372-020-0659-4. Epub 2020 Mar 23.

Abstract

OBJECTIVE

Neonatal neurodevelopmental follow-up clinic provides continued surveillance and assessment of high-risk premature infants. We hypothesized that attrition is associated with race and social factors.

STUDY DESIGN

We performed a retrospective cohort study of neonates born at 26-32 weeks gestation who were admitted to a level IV neonatal intensive care unit. Maternal and neonatal characteristics and follow-up attendance were collected. Statistical analysis was performed with significance set at p value < 0.05.

RESULTS

In total, 237 neonates met study criteria. There was a 62% loss to follow-up over 2 years. Factors associated with loss to follow-up included older gestational age, African American race, and maternal cigarette smoking. Protective factors included older maternal age, a neonatal diagnosis of bronchopulmonary dysplasia, and longer hospital length of stay.

CONCLUSIONS

Social disparities negatively impact neonatal follow-up clinic attendance. Efforts to identify and target high-risk populations must be started during initial hospitalization before infants are lost to follow-up.

摘要

目的

新生儿神经发育随访门诊对高危早产儿进行持续监测和评估。我们假设失访与种族和社会因素有关。

研究设计

我们对妊娠26 - 32周出生并入住四级新生儿重症监护病房的新生儿进行了一项回顾性队列研究。收集了母亲和新生儿的特征以及随访情况。进行统计学分析,显著性设定为p值<0.05。

结果

共有237名新生儿符合研究标准。两年内失访率为62%。与失访相关的因素包括孕龄较大、非裔美国人种族以及母亲吸烟。保护因素包括母亲年龄较大、新生儿支气管肺发育不良诊断以及住院时间较长。

结论

社会差异对新生儿随访门诊的就诊率产生负面影响。在婴儿失访之前,必须在初次住院期间就开始努力识别和针对高危人群。

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