Developmental Outcomes of Extremely Preterm Infants with a Need for Child Protective Services Supervision

Elisabeth C McGowan; Abbot R Laptook; Jean Lowe; Myriam Peralta-Carcelen; Dhuly Chowdhury; Rosemary D Higgins; Susan R Hintz; Betty R Vohr; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

doi:10.1016/j.jpeds.2019.07.063

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Developmental Outcomes of Extremely Preterm Infants with a Need for Child Protective Services Supervision

Journal article

Open access

Peer reviewed

Developmental Outcomes of Extremely Preterm Infants with a Need for Child Protective Services Supervision

Elisabeth C McGowan, Abbot R Laptook, Jean Lowe, Myriam Peralta-Carcelen, Dhuly Chowdhury, Rosemary D Higgins, Susan R Hintz, Betty R Vohr and Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

The Journal of pediatrics, Vol.215, pp.41-49.e4

12/2019

DOI: 10.1016/j.jpeds.2019.07.063

PMCID: PMC6988387

PMID: 31500860

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https://www.ncbi.nlm.nih.gov/pmc/articles/6988387View

Open Access

Abstract

To evaluate neurodevelopmental outcomes of preterm infants with need for Child Protective Services (CPS) supervision at hospital discharge compared with those discharged without CPS supervision. For infants born at <27 weeks of gestation between 2006 and 2013, prospectively collected maternal and neonatal characteristics and 18- to 26-month corrected age follow-up data were analyzed. Bayley-III cognitive and language scores of infants with discharge CPS supervision were compared with infants without CPS supervision using regression analysis while adjusting for potentially confounding variables, including entering CPS after discharge from the hospital. Of the 4517 preterm infants discharged between 2006 and 2013, 255 (5.6%) were discharged with a need for CPS supervision. Mothers of infants with CPS supervision were significantly more likely to be younger, single, and gravida ≥3; to have less than a high school education; and to have a singleton pregnancy and less likely to have received prenatal care or antenatal steroids. Despite similar birth weight and medical morbidities, the CPS group had longer hospital stays compared with the non-CPS group. In adjusted analysis, cognitive scores were points lower (B = -1.94; 95% CI, -3.88 to -0.08; P = .04) in the CPS at discharge group compared with the non-CPS group. In children who entered CPS supervision after hospital discharge (an additional 106 infants), cognitive scores were 4 points lower (β = -4.76; 95% CI, -7.47 to -2.05; P < .001) and language scores were 5 points lower (β = -4.93; 95% CI, -8.00 to -1.86; P = .002). Extremely preterm infants discharged from the hospital with CPS supervision or entering CPS postdischarge are at increased risk for cognitive delay at 2 years of age. Opportunities exist to intervene and potentially improve outcomes in this vulnerable group of children.

Child Development

Pregnancy

United States

Adult

Child Protective Services - organization & administration

Child, Preschool

Female

Follow-Up Studies

Gestational Age

Humans

Infant

Infant, Extremely Premature

Infant, Newborn

Male

Patient Discharge

Prenatal Care - organization & administration

Retrospective Studies

Time Factors

Details

Title: Subtitle: Developmental Outcomes of Extremely Preterm Infants with a Need for Child Protective Services Supervision
Creators: Elisabeth C McGowan - Brown University
Abbot R Laptook - Brown University
Jean Lowe - University of New Mexico
Myriam Peralta-Carcelen - University of Alabama at Birmingham
Dhuly Chowdhury - RTI International
Rosemary D Higgins - National Institutes of Health
Susan R Hintz - Lucile Packard Children's Hospital
Betty R Vohr - Brown University
Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
Contributors: Edward F Bell (Contributor) - University of Iowa, Neonatology
Tarah T Colaizy (Contributor) - University of Iowa, Neonatology
Resource Type: Journal article
Publication Details: The Journal of pediatrics, Vol.215, pp.41-49.e4
DOI: 10.1016/j.jpeds.2019.07.063
PMID: 31500860
PMCID: PMC6988387
NLM abbreviation: J Pediatr
ISSN: 0022-3476
eISSN: 1097-6833
Grant note: UG1 HD040689 / NICHD NIH HHS UG1 HD087226 / NICHD NIH HHS UL1 TR003167 / NCATS NIH HHS KL2 TR003168 / NCATS NIH HHS UG1 HD027904 / NICHD NIH HHS UG1 HD027853 / NICHD NIH HHS
Language: English
Date published: 12/2019
Academic Unit: Stead Family Department of Pediatrics; Neonatology
Record Identifier: 9984353864702771

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