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Social disparities negatively impact neonatal follow-up clinic attendance of premature infants discharged from the neonatal intensive care unit

Journal of Perinatology volume 40, pages 790–797 (2020)Cite this article

Subjects

Abstract

Objective

Neonatal neurodevelopmental follow-up clinic provides continued surveillance and assessment of high-risk premature infants. We hypothesized that attrition is associated with race and social factors.

Study design

We performed a retrospective cohort study of neonates born at 26–32 weeks gestation who were admitted to a level IV neonatal intensive care unit. Maternal and neonatal characteristics and follow-up attendance were collected. Statistical analysis was performed with significance set at p value < 0.05.

Results

In total, 237 neonates met study criteria. There was a 62% loss to follow-up over 2 years. Factors associated with loss to follow-up included older gestational age, African American race, and maternal cigarette smoking. Protective factors included older maternal age, a neonatal diagnosis of bronchopulmonary dysplasia, and longer hospital length of stay.

Conclusions

Social disparities negatively impact neonatal follow-up clinic attendance. Efforts to identify and target high-risk populations must be started during initial hospitalization before infants are lost to follow-up.

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Fig. 1: Geographical distribution of study participants based upon number of neonatal follow-up visits attended.
Fig. 2: Kaplan–Meier survival curve of proportion of neonatal follow-up attendance over a 2-year period.

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Acknowledgements

Statistical support was provided through the Division of Quantitative Health Sciences. This study was supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant Number UL1TR001436. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. We would like to thank the MCW Division of Neonatology and the members of the CHW Neonatal Neurocritical Care Program for their support.

Funding

This study was also supported by internal funding through MCW Department of Pediatrics.

Author information

Authors and Affiliations

  1. Medical College of Wisconsin Affiliated Hospitals, Milwaukee, WI, USA

    Corinne Swearingen

  2. Division of Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, WI, USA

    Pippa Simpson

  3. Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA

    Erwin Cabacungan & Susan Cohen

Authors
  1. Corinne Swearingen
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  2. Pippa Simpson
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  3. Erwin Cabacungan
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  4. Susan Cohen
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Contributions

CS designed the study and wrote the manuscript with guidance from EC and SC. EC performed the statistical analysis with oversight from the Division of Quantitative Health Sciences.

Corresponding author

Correspondence to Susan Cohen.

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The authors declare that they have no conflict of interest.

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Swearingen, C., Simpson, P., Cabacungan, E. et al. Social disparities negatively impact neonatal follow-up clinic attendance of premature infants discharged from the neonatal intensive care unit. J Perinatol 40, 790–797 (2020). https://doi.org/10.1038/s41372-020-0659-4

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