Maternal neighborhood deprivation and its association with early childhood neurodevelopmental impairment in extremely preterm infants

Abstract Objective Evaluate whether maternal Area Deprivation Index (ADI) is associated with neurodevelopmental impairment (NDI) at age 2 in extremely preterm infants. Study design Retrospective cohort study of infants <29 weeks’ gestation at four NICUs spanning multiple US regions. We analyzed the relationship between ADI and NDI, defined as no/mild, moderate, or severe based on the lowest component score on the Bayley Scales of Infant and Toddler Development exam, using a Bayesian ordinal cumulative logit hurdle model. Adjustments included sex, birthweight, maternal race/ethnicity, outborn, severe intraventricular hemorrhage, and late-onset sepsis or necrotizing enterocolitis. Results Of 1278 infants studied, 275 underwent a Bayley exam. Lower birthweight, male sex, and inborn status were associated with undergoing a Bayley exam. Higher ADI, lower birthweight, male sex, and late-onset sepsis were linked to more severe NDI. ADI was independently associated with NDI risk. Conclusion Maternal deprivation measured by ADI was associated with NDI risk.