WIP 49 - Indicators of Health-Related Social Needs as Predictors for Birth and Lactation Outcomes among Neonates with Critical Congenital Heart Defects: A Preliminary Analysis

Poster Number: WIP 49
Publication Number: WIP 49.885

Background: Malnutrition is closely associated with birth weight among neonates with congenital heart defects (CHD). Emerging evidence suggests human milk and direct chest/breastfeeding (C/BF) promote growth, but there are persistent barriers to achieving ideal lactation outcomes in this population. Food insecurity, racism, and health equity disparities have been linked with lower birth weight, lower gestational age at birth, and cesarean delivery (birth outcomes) and adverse lactation outcomes (lower initiation, maintenance, and intensity of feeds with maternal/parental milk and/or direct C/BF) in term and preterm neonates, but there are limited data in neonates with CHD.

Objective: The purpose of this analysis is to explore the how birth and lactation outcomes are associated with food insecurity, racism, and health equity in a cohort of neonates with CHD.

Design/Methods: Post hoc analysis of retrospective data from an electronic health record review of a sub-cohort of neonates (n=20) who underwent surgical repair of a CHD at a children’s hospital in Pennsylvania between April 1st, 2016 and April 30th, 2020. All neonates in this sub-cohort resided in the same county as the children’s hospital, were hospitalized within 72 hours after birth, born >/= 37 weeks gestation, received prostaglandins, and had no other defects or disorders. Descriptive statistics were generated to show cohort characteristics. Race and Conduent Healthy Communities Institute’s Food Insecurity Index and Health Equity Index were used as focal predictors. Birth outcomes were birth weight and weight-for-age z-score, gestational age, and delivery mode. Lactation outcomes were percentage of enteral feeds that were parental milk and human milk during the first 28 days of life, percentage of enteral feeds that were parental milk on day of life 28 or discharge, and frequency of direct chest/breastfeeding. Multiple linear and binary logistic regression were used for analysis. Institutional Review Board approval was obtained for the primary study.