Impact of Social Determinants on Home Oxygen Therapy Duration in Preterm Infants: A Study Utilizing the Childhood Opportunity Index.

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Pulmonology Pub Date : 2025-05-01 DOI:10.1002/ppul.71132

Kristen Richard, Rachel D'Anna, Suzanne E Dahlberg, Heather White, Amit Agarwal, Katherine Edeburn, Catherine A Sheils, Lawrence M Rhein, Jonathan C Levin

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引用次数: 0

Abstract

Introduction: Recorded home oximetry (RHO) standardizes and reduces home oxygen therapy (HOT) duration in infants with post-prematurity related lung disease (PPRD). The impact of social determinants of health (SDoH) on HOT outcomes using RHO is unknown. We examined whether the childhood opportunity index (COI) and maternal race influence HOT duration in infants with PPRD using RHO.

Methods: This secondary analysis of a cohort from the RHO Implementation Study used COI determined by zip code, dichotomized as low (very low/low) and high (moderate/high/very high) opportunity. Time-to-discontinuation was stratified by COI and maternal race, estimated using Kaplan-Meier methodology. Cox regression (stratified for NICU duration by quantiles) modeled the impact of neonatal variables and COI on HOT duration.

Results: Ninety seven infants were included (34 low COI, 63 high COI). Median HOT duration was 96 days for low COI and 64 days for high COI (95% CI: 57-157; 95% CI: 52-80, p = 0.3). Longer NICU stay decreased HOT discontinuation risk (HR: 0.99, 95% CI: 0.99-1.00, p = 0.002). High COI was not associated with an increased risk of HOT discontinuation (HR: 1.44, 95% CI: 0.83-2.5, p = 0.195). Infants born to Black mothers had longer NICU stays and more often low COI, but not longer HOT use (HR: 1.49, 95% CI: 0.8-2.79, p = 0.206).

Conclusion: In a multicenter cohort of infants with PPRD discharged on HOT, low COI, and Black maternal race were not associated with an increased risk for prolonged oxygen use when following a protocoled weaning approach. Further research is needed to assess if standardized HOT management mitigates SDoH-related disparities in oxygen duration.

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社会因素对早产儿家庭氧疗持续时间的影响：一项利用儿童机会指数的研究。

简介：记录家庭血氧仪（RHO）标准化和减少家庭氧疗（HOT）持续时间的婴儿早产儿相关肺病（PPRD）。健康的社会决定因素（SDoH）对使用RHO的HOT结果的影响尚不清楚。我们使用RHO检查童年机会指数（COI）和母亲种族是否影响PPRD婴儿的HOT持续时间。方法：对来自RHO实施研究的队列进行二次分析，使用由邮政编码确定的COI，分为低（非常低/低）和高（中等/高/非常高）机会。停用时间按COI和母亲种族分层，使用Kaplan-Meier方法估计。Cox回归（按分位数分层NICU持续时间）模拟了新生儿变量和COI对HOT持续时间的影响。结果：纳入97例患儿（低COI 34例，高COI 63例）。低COI组的中位热持续时间为96天，高COI组为64天(95% CI: 57-157；95% CI: 52-80, p = 0.3)。NICU停留时间越长，HOT停药风险降低（HR: 0.99, 95% CI: 0.99-1.00, p = 0.002）。高COI与HOT停药风险增加无关（HR: 1.44, 95% CI: 0.83-2.5, p = 0.195）。黑人母亲所生的婴儿在新生儿重症监护室停留的时间更长，COI更低，但使用HOT的时间更长（HR: 1.49, 95% CI: 0.8-2.79, p = 0.206）。结论：在一个多中心队列的PPRD患儿在HOT出院时，低COI和黑人母亲种族与遵循协议断奶方法时延长氧气使用的风险增加无关。需要进一步的研究来评估标准化热管理是否减轻了与sdoh相关的氧持续时间差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Pulmonology 医学-呼吸系统

CiteScore

6.00

自引率

12.90%

发文量

468

审稿时长

3-8 weeks

期刊介绍： Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases. PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.