超越收入：物质困难与早产儿的健康和医疗保健。
Beyond income: material hardship and the health and healthcare of premature children.
机构信息
Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
Evans Center for Implementation and Improvement Sciences, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
出版信息
J Perinatol. 2023 Mar;43(3):357-363. doi: 10.1038/s41372-022-01560-w. Epub 2022 Nov 17.
OBJECTIVES
To estimate national prevalence of household hardships (food insufficiency, financial hardship, and difficulty paying medical bills) among children born term and preterm; and examine associations of household hardships with preterm children's outcomes (health status, emergency room visits, and unmet healthcare needs).
METHODS
We studied 24,026 children aged 0-3 years born term, preterm with moderately low birth weight (1501-2499 grams) and preterm with very low birth weight (VLBW; ≤1500 grams). Using propensity score matching to control for correlates of poverty, we examined associations of hardships and child outcomes.
RESULTS
Compared with term, households with preterm VLBW children had >2-fold higher odds of financial hardship (aOR:2.63; 95% CI: 1.26-5.46) and >5-fold higher odds of difficulty paying bills (aOR:5.60; 95% CI: 2.35-10.35). Matching for sociodemographics, special healthcare needs, income and receipt of public benefits, hardships were independently associated with adverse preterm children's outcomes.
CONCLUSIONS
Addressing household hardships is needed to optimize preterm child outcomes.
目的
估计足月和早产儿家庭所面临的困难（食物不足、经济困难和医疗费用支付困难）的全国流行率；并研究家庭困难与早产儿结局（健康状况、急诊就诊和未满足的医疗保健需求）之间的关系。
方法
我们研究了 24026 名 0-3 岁的足月、早产儿（出生体重 1501-2499 克）和极低出生体重儿（VLBW；≤1500 克）。使用倾向评分匹配来控制贫困的相关因素，我们研究了困难与儿童结局之间的关系。
结果
与足月儿相比，患有 VLBW 早产儿的家庭面临财务困难的可能性高出两倍以上（调整后的优势比[aOR]：2.63；95%置信区间[CI]：1.26-5.46），且支付账单困难的可能性高出 5 倍以上（aOR：5.60；95% CI：2.35-10.35）。在匹配社会人口统计学、特殊医疗需求、收入和公共福利的情况下，困难与早产儿的不良结局独立相关。
结论
需要解决家庭困难问题，以优化早产儿的结局。
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