社会脆弱性指数与新生儿不良结局之间的关系。

IF 1.5 4区 医学 Q3 OBSTETRICS & GYNECOLOGY American journal of perinatology Pub Date : 2024-10-30 DOI:10.1055/a-2419-8539
Charlotte B McCarley, Christina T Blanchard, Ariann Nassel, Macie L Champion, Ashley N Battarbee, Akila Subramaniam
{"title":"社会脆弱性指数与新生儿不良结局之间的关系。","authors":"Charlotte B McCarley, Christina T Blanchard, Ariann Nassel, Macie L Champion, Ashley N Battarbee, Akila Subramaniam","doi":"10.1055/a-2419-8539","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong> Identifying underlying social risk factors for neonatal intensive care unit (NICU) admission is important for designing interventions to reduce adverse outcomes. We aimed to determine whether a patient's exposure to community-level stressors as measured by the social vulnerability index (SVI) is associated with NICU admission.</p><p><strong>Study design: </strong> Retrospective cohort study (2014-2018) of patients delivering a liveborn ≥ 22 weeks' gestation at a quaternary care center. Patient addresses were used to assign each individual a composite SVI and theme score. The primary exposure was a composite SVI score categorized into tertiles. The primary outcome was NICU admission. Secondary outcomes included NICU length of stay and neonatal morbidity composite. Multivariable logistic regression was performed to estimate the association between composite SVI and outcomes (low SVI as referent). We secondarily compared mean composite and theme SVI scores; individual components of each theme were also compared.</p><p><strong>Results: </strong> From 2014 to 2018, 13,757 patients were included; 2,837 (21%) had a neonate with NICU admission. Patients with higher SVI were more likely to self-identify as Black race and have medical comorbidities. Living in areas with moderate or high SVI was not associated with NICU admission (moderate SVI adjusted odds ratio [aOR]: 1.13, 95% confidence interval [CI]: 0.96-1.34; high SVI aOR: 1.12, 95% CI: 0.95-1.33). Moderate SVI was associated with increased neonatal morbidity (aOR: 1.18, 95% CI: 1.001-1.38). In an analysis of SVI as a continuous variable, mean SVI scores were significantly higher in individuals who had an infant admitted to the NICU. Those requiring NICU admission lived in areas with lower per capita income and a higher number of mobile homes (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong> Patients living in areas with moderate or high SVI were not shown to have higher odds of having a neonate admitted to the NICU. Neonatal morbidity was higher in those living in areas with moderate SVI. Increased access to social services may improve neonatal outcomes.</p><p><strong>Key points: </strong>· Mean SVI scores are higher in those with a neonate admitted to the NICU.. · There was no observed association between moderate and high SVI scores and NICU admission.. · Moderate SVI is associated with an increased odds of overall neonatal morbidity.. · Greater exposure to low income may be associated with NICU admission..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Association between the Social Vulnerability Index and Adverse Neonatal Outcomes.\",\"authors\":\"Charlotte B McCarley, Christina T Blanchard, Ariann Nassel, Macie L Champion, Ashley N Battarbee, Akila Subramaniam\",\"doi\":\"10.1055/a-2419-8539\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong> Identifying underlying social risk factors for neonatal intensive care unit (NICU) admission is important for designing interventions to reduce adverse outcomes. We aimed to determine whether a patient's exposure to community-level stressors as measured by the social vulnerability index (SVI) is associated with NICU admission.</p><p><strong>Study design: </strong> Retrospective cohort study (2014-2018) of patients delivering a liveborn ≥ 22 weeks' gestation at a quaternary care center. Patient addresses were used to assign each individual a composite SVI and theme score. The primary exposure was a composite SVI score categorized into tertiles. The primary outcome was NICU admission. Secondary outcomes included NICU length of stay and neonatal morbidity composite. Multivariable logistic regression was performed to estimate the association between composite SVI and outcomes (low SVI as referent). We secondarily compared mean composite and theme SVI scores; individual components of each theme were also compared.</p><p><strong>Results: </strong> From 2014 to 2018, 13,757 patients were included; 2,837 (21%) had a neonate with NICU admission. Patients with higher SVI were more likely to self-identify as Black race and have medical comorbidities. Living in areas with moderate or high SVI was not associated with NICU admission (moderate SVI adjusted odds ratio [aOR]: 1.13, 95% confidence interval [CI]: 0.96-1.34; high SVI aOR: 1.12, 95% CI: 0.95-1.33). Moderate SVI was associated with increased neonatal morbidity (aOR: 1.18, 95% CI: 1.001-1.38). In an analysis of SVI as a continuous variable, mean SVI scores were significantly higher in individuals who had an infant admitted to the NICU. Those requiring NICU admission lived in areas with lower per capita income and a higher number of mobile homes (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong> Patients living in areas with moderate or high SVI were not shown to have higher odds of having a neonate admitted to the NICU. Neonatal morbidity was higher in those living in areas with moderate SVI. Increased access to social services may improve neonatal outcomes.</p><p><strong>Key points: </strong>· Mean SVI scores are higher in those with a neonate admitted to the NICU.. · There was no observed association between moderate and high SVI scores and NICU admission.. · Moderate SVI is associated with an increased odds of overall neonatal morbidity.. · Greater exposure to low income may be associated with NICU admission..</p>\",\"PeriodicalId\":7584,\"journal\":{\"name\":\"American journal of perinatology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-10-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of perinatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1055/a-2419-8539\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of perinatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2419-8539","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

目的:确定新生儿重症监护室(NICU)入院的潜在社会风险因素对于设计干预措施以减少不良后果非常重要。我们旨在确定以社会脆弱性指数(SVI)衡量的患者暴露于社区层面的压力因素是否与入住新生儿重症监护室有关:研究设计:回顾性队列研究(2014-2018 年),对象为在一家四级护理中心分娩的妊娠期≥ 22 周的活产婴儿。患者地址用于为每个人分配综合 SVI 和主题得分。主要暴露指标为综合 SVI 分值,并分为三等分。主要结果为新生儿重症监护室入院率。次要结果包括新生儿重症监护室住院时间和新生儿综合发病率。我们进行了多变量逻辑回归,以估计综合 SVI 与结果之间的关联(以低 SVI 为参照)。其次,我们比较了综合 SVI 和主题 SVI 的平均得分;还比较了每个主题的各个组成部分:从 2014 年到 2018 年,共纳入了 13757 名患者;2837 名(21%)新生儿入住了 NICU。SVI较高的患者更有可能自我认同为黑人种族,并有医疗合并症。生活在中度或高度 SVI 的地区与新生儿重症监护病房的入院率无关(中度 SVI 调整赔率 [aOR]:1.13,95% 置信区间):1.13,95% 置信区间 [CI]:0.96-1.34;高 SVI aOR:1.12,95% 置信区间 [CI]:0.95-1.33)。中度 SVI 与新生儿发病率增加有关(aOR:1.18,95% CI:1.001-1.38)。在将 SVI 作为连续变量进行分析时,有婴儿住进新生儿重症监护室的人的平均 SVI 分数明显更高。需要入住新生儿重症监护室的患者居住在人均收入较低、活动房屋数量较多的地区(P 结语):在中度或高度 SVI 地区生活的患者,其新生儿入住新生儿重症监护室的几率并不高。中度 SVI 地区的新生儿发病率较高。增加获得社会服务的机会可能会改善新生儿的预后:- 新生儿重症监护室新生儿的平均 SVI 分数较高。- 中度和高度SVI评分与新生儿重症监护室入院之间没有关联。- 中度SVI与新生儿总体发病率增加有关。- 较高的低收入可能与新生儿重症监护室的收治有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
The Association between the Social Vulnerability Index and Adverse Neonatal Outcomes.

Objective:  Identifying underlying social risk factors for neonatal intensive care unit (NICU) admission is important for designing interventions to reduce adverse outcomes. We aimed to determine whether a patient's exposure to community-level stressors as measured by the social vulnerability index (SVI) is associated with NICU admission.

Study design:  Retrospective cohort study (2014-2018) of patients delivering a liveborn ≥ 22 weeks' gestation at a quaternary care center. Patient addresses were used to assign each individual a composite SVI and theme score. The primary exposure was a composite SVI score categorized into tertiles. The primary outcome was NICU admission. Secondary outcomes included NICU length of stay and neonatal morbidity composite. Multivariable logistic regression was performed to estimate the association between composite SVI and outcomes (low SVI as referent). We secondarily compared mean composite and theme SVI scores; individual components of each theme were also compared.

Results:  From 2014 to 2018, 13,757 patients were included; 2,837 (21%) had a neonate with NICU admission. Patients with higher SVI were more likely to self-identify as Black race and have medical comorbidities. Living in areas with moderate or high SVI was not associated with NICU admission (moderate SVI adjusted odds ratio [aOR]: 1.13, 95% confidence interval [CI]: 0.96-1.34; high SVI aOR: 1.12, 95% CI: 0.95-1.33). Moderate SVI was associated with increased neonatal morbidity (aOR: 1.18, 95% CI: 1.001-1.38). In an analysis of SVI as a continuous variable, mean SVI scores were significantly higher in individuals who had an infant admitted to the NICU. Those requiring NICU admission lived in areas with lower per capita income and a higher number of mobile homes (p < 0.001).

Conclusion:  Patients living in areas with moderate or high SVI were not shown to have higher odds of having a neonate admitted to the NICU. Neonatal morbidity was higher in those living in areas with moderate SVI. Increased access to social services may improve neonatal outcomes.

Key points: · Mean SVI scores are higher in those with a neonate admitted to the NICU.. · There was no observed association between moderate and high SVI scores and NICU admission.. · Moderate SVI is associated with an increased odds of overall neonatal morbidity.. · Greater exposure to low income may be associated with NICU admission..

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
American journal of perinatology
American journal of perinatology 医学-妇产科学
CiteScore
5.90
自引率
0.00%
发文量
302
审稿时长
4-8 weeks
期刊介绍: The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields. The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field. All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication. The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.
期刊最新文献
Is the Risk of Intrahepatic Cholestasis Increased with Supplemental Progesterone? Management, Utilization, and Outcomes of Preterm Labor in an Integrated Health Care System. Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy: Reducing Variability in Practice through a Collaborative Telemedicine Initiative. Antenatal Breast Milk Expression Survey of Individuals Whose Pregnancy Was Complicated by Diabetes: Exploring Knowledge, Perceptions, Experiences, and Milk Volume Expressed. Treatment for Neonatal Abstinence Syndrome Using Nonpharmacological Interventions.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1