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Neighborhood Disadvantage and Early Respiratory Outcomes in Very Preterm Infants with Bronchopulmonary Dysplasia.
Deschamps, Juliette; Boucekine, Mohamed; Fayol, Laurence; Dubus, Jean Christophe; Nauleau, Steve; Garcia, Patricia; Boubred, Farid.
Afiliação
  • Deschamps J; Neonatal Unit, University Hospital of La Conception, AP-HM, AMU, Marseille, France.
  • Boucekine M; CEReSS Health Service Research and Quality of Life Center, AMU, EA 3279, Marseille, France.
  • Fayol L; Neonatal Unit, University Hospital of La Conception, AP-HM, AMU, Marseille, France.
  • Dubus JC; Department of Pediatric Medicine and Pediatric Pulmonary Medicine, Timone University Children's Hospital, AP-HM, Marseille, France.
  • Nauleau S; Regional Health Agency Provence-Alpes-Côtes d'Azur, Marseille, France.
  • Garcia P; Neonatal Unit, University Hospital of La Conception, AP-HM, AMU, Marseille, France.
  • Boubred F; Neonatal Unit, University Hospital of La Conception, AP-HM, AMU, Marseille, France; Aix-Marseille University, INSERM, INRAE, C2VN, Marseille, France. Electronic address: farid.boubred@ap-hm.fr.
J Pediatr ; 237: 177-182.e1, 2021 Oct.
Article em En | MEDLINE | ID: mdl-34216631
OBJECTIVE: To investigate the impact of neighborhood conditions on respiratory-related hospital admissions in the first year after discharge from the neonatal unit in a population of infants born very preterm with bronchopulmonary dysplasia (BPD). STUDY DESIGN: Very preterm infants (gestational age <33 weeks) who had BPD at 36 weeks postconceptional age and who received follow-up in a French regional medical network were included. Socioeconomic context was estimated using a neighborhood-based Socioeconomic Deprivation Index. Poisson regression analysis was used to identify risk factors associated with rehospitalization. RESULTS: The study included 423 infants with a mean gestational age of 27 ± 2 weeks and mean birth weight of 941 ± 277 g; 51% of the population lived in a disadvantaged area. The hospital admission rate was increased by 8.8% for infants living in affluent areas and by 24% for those living in disadvantaged areas (P <.01) and reached 30% in extremely preterm infants from disadvantaged areas. After adjusting for perinatal characteristics, home oxygen therapy, and season of birth, the respiratory-related hospitalization rate was almost 3-fold higher in infants living in disadvantaged areas, with an adjusted incidence rate ratio of 2.79 (95% CI, 1.29-6.09; P <.01). CONCLUSIONS: Disadvantaged neighborhoods adversely impact early respiratory outcomes in infants born very preterm with BPD. The social context should be considered in routine follow-up care of children born preterm. Further studies investigating the underlying mechanisms are warranted for implementing preventive strategies.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Displasia Broncopulmonar / Características de Residência / Hospitalização Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Infant / Male / Newborn País/Região como assunto: Europa Idioma: En Revista: J Pediatr Ano de publicação: 2021 Tipo de documento: Article País de afiliação: França País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Displasia Broncopulmonar / Características de Residência / Hospitalização Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Infant / Male / Newborn País/Região como assunto: Europa Idioma: En Revista: J Pediatr Ano de publicação: 2021 Tipo de documento: Article País de afiliação: França País de publicação: Estados Unidos