Neonatal and Perinatal Medicine Fellow Vanderbilt University School of Medicine Nashville, Tennessee, United States
Background: Preterm infants, especially those of low birth weight (LBW), face a heightened risk of adverse healthcare and developmental outcomes post-NICU discharge, often necessitating ongoing caregiver support for healthcare needs. Social determinants of health further shape post-NICU discharge outcomes, with prior research demonstrating financial strain among caregivers of LBW infants; however, nationally representative research is sparse. Objective: Our aim is to examine the association between caregiver employment status and having a preterm infant using data from the National Survey of Children’s Health (NSCH). We specifically aim to assess whether a caregiver retains a job due to need for child’s health insurance, reduces work hours due to a child’s healthcare needs, or leaves the workforce due to a child’s healthcare needs. Design/Methods: This study received an exemption from review by the Vanderbilt University Medical Center IRB. We are conducting a secondary analysis of NSCH data spanning 2018-2022 of children aged 0-3 years. We have compiled the survey data into multi-year estimates adjusting for survey weights. Term birth is defined as gestational age of ≥37 weeks. Our sample is stratified consistent with prior literature as, (1) term and ≥2500g; (2) LBW: preterm and 1501-2499g; and (3) very low birth weight (VLBW): preterm and ≤1500g. We estimated descriptive statistics for our population of interest and prepared a demographics table examining key characteristics. Next, we will use multivariable logistic regression to examine birth timing with caregiver employment; covariates of interest include age, special healthcare need status, race/ethnicity, insurance status, caregiver education, caregiver marital status, and household income relative to the federal poverty level. We will present odds ratios with 95% confidence intervals for all outcomes. Thus far, our unweighted sample includes 35,939 term, 1,771 LBW and 407 VLBW infants. Our weighted sample includes 12,438,243 term, 641,647 LBW and 140,993 VLBW infants. Remaining analysis will conclude by March 1, 2024.
