Resident Physician Weill Cornell Medicine New York City, New York, United States
Background: Racial, ethnic, and socioeconomic disparities in maternal and neonatal health outcomes are evident from an increased risk of preterm delivery, neonatal mortality and morbidity, and neurodevelopmental impairment (Linsell et al., 2015). The American Academy of Pediatrics recommends that high-risk patients be enrolled in a program that specializes in neurodevelopmental assessment. Despite the benefits of high-risk infant follow-up (HRIF), long-term attendance is challenging (Tang et al., 2018). Infants of a single parent, infants born to Black mothers, families residing further from clinic, and families from under-resourced neighborhoods are less likely to follow up (Ballantyne et al., 2014; Fraiman et al., 2022). Objective: To examine the medical and socio-demographic factors impacting referral patterns, rates of follow-up and attrition from a single center level IV NICU to HRIF clinic. Design/Methods: This is a retrospective review of all patients admitted to the level IV NICU at our home institution between January 2021 and December 2022. Patients qualifying for referral to HRIF (gestational age (GA) ≤ 32 weeks, birth weight (BW) ≤ 1500 grams, encephalopathy, stroke, seizures, congenital infection, etc.) are included in the analysis. Medical factors (GA, BW, sex, morbidities e.g. chronic lung disease, intraventricular hemorrhage, necrotizing enterocolitis) and socio-demographic factors (race, ethnicity, primary language) will be evaluated for association with likelihood of referral to HRIF clinic, attending initial visit, and sustained follow-up. The data will be summarized using descriptive statistics (means and standard deviations for continuous variables and frequencies for categorical variables). We will perform bivariate analysis using Student’s t-test for continuous variables and Fisher’s Exact Test for categorical variables. Logistic regression analyses will be conducted, taking into account maternal and neonatal characteristics and socio-economic determinants of health, to determine predictors of referral to HRIF and clinic attendance. This study is IRB approved.
