有公共和私人保险的早产儿的健康社会决定因素及语言发育结果
Social determinants of health and language outcomes in preterm infants with public and private insurance.
作者信息
Batta Arya, McGowan Elisabeth C, Tucker Richard, Vohr Betty
机构信息
Department of Pediatrics, Division of Neonatal Medicine, Women & Infants Hospital of Rhode Island, Alpert Medical School of Brown University, Providence, RI, USA.
出版信息
J Perinatol. 2025 Mar;45(3):359-364. doi: 10.1038/s41372-024-02082-3. Epub 2024 Jul 31.
OBJECTIVE
To evaluate associations of maternal social determinants of health (SDOH) with language outcomes of preterm infants with public and private insurance.
STUDY DESIGN
Single center study of 375 neonates born ≤ 28 weeks. Perinatal characteristics were collected, and the Bayley III was administered at 18-24 months. Primary outcome was language scores of <85. Bivariate and multivariable analyses were used to compare groups.
RESULTS
Mothers with public insurance had higher rates of psychosocial risk factors. In regression analysis, People of Color (aOR 2.4, 1.47-4.04), non-English speaking household (aOR 4.05, 1.47-11.15) and public insurance (aOR 2.03, 1.18-3.49) significantly increased the odds of having a language composite score of <85, whereas breast milk (aOR 0.47, 0.28-0.79) was protective.
CONCLUSIONS
Preterm infants with public insurance are at increased risk of exposure to multiple SDOH which are independently associated with language delay at 18-24 months.
目的
评估母亲健康的社会决定因素（SDOH）与有公共保险和私人保险的早产儿语言发育结果之间的关联。
研究设计
对375名出生孕周≤28周的新生儿进行单中心研究。收集围产期特征，并在18至24个月时进行贝利婴幼儿发展量表第三版（Bayley III）测试。主要结局是语言得分<85。采用双变量和多变量分析对各组进行比较。
结果
有公共保险的母亲心理社会风险因素发生率较高。在回归分析中，有色人种（调整后比值比[aOR]为2.4，1.47至4.04）、非英语家庭（aOR为4.05，1.47至11.15）和公共保险（aOR为2.03，1.18至3.49）显著增加了语言综合得分<85的几率，而母乳喂养（aOR为0.47，0.28至0.79）具有保护作用。
结论
有公共保险的早产儿暴露于多种健康社会决定因素的风险增加，这些因素与18至24个月时的语言发育迟缓独立相关。
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