Dataset Information

Emergency department utilization during the first year of life among infants born to women at risk of disability.

ABSTRACT:

Background

Women with disabilities are at risk for poor birth outcomes. Little is known about longer-term health and healthcare utilization of infants of women with disabilities.

Objectives

We identified women at risk for disability and evaluated their infants' emergency department (ED) utilization during the first year of life.

Study design

This population-based cohort study used Massachusetts 2007-2009 birth certificates linked to 2007-2010 hospital discharge data. Access Risk Classification System categorized ICD-9 CM/CPT codes into disability risk categories. Infant ED visits were evaluated overall and by severity (emergent/intermediate vs. non-emergent). Cox proportional hazards models provided adjusted estimates. Results were stratified by gestational age (preterm, < 37 weeks, term, 37 + weeks).

Results

Of 218,599 women, 6.7% were at risk of disability. Infants born to women at risk had a higher rate of ED visits in their first year than infants born to women not at risk: 0.85 visits/person-year (95% CI 0.84-0.87) vs. 0.55 (0.55-0.55) for term, 0.74 (0.70-0.77) vs. 0.55 (0.54-0.56) for preterm. Utilization varied by maternal diagnosis. Emergent/intermediate and non-emergent visits were both elevated among infants born to women at risk for disability. In adjusted analyses, term infants of women with musculoskeletal diagnoses (HR = 1.3, 95% CI 1.2-1.4) and preterm infants of women with circulatory diagnoses (HR = 1.2, 1.0-1.3) had the highest hazards of ED visit vs. infants of women not at risk of disability.

Conclusion

Maternal disability risk is associated with postnatal infant ED utilization; utilization varies by maternal diagnosis. Interventions to improve health of infants born to women with disabilities are warranted.

SUBMITTER: Clements KM

PROVIDER: S-EPMC9305628 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Emergency department utilization during the first year of life among infants born to women at risk of disability.

Clements Karen M KM Zhang Jianying J Long-Bellil Linda M LM Mitra Monika M

Disability and health journal 20190801 1

<h4>Background</h4>Women with disabilities are at risk for poor birth outcomes. Little is known about longer-term health and healthcare utilization of infants of women with disabilities.<h4>Objectives</h4>We identified women at risk for disability and evaluated their infants' emergency department (ED) utilization during the first year of life.<h4>Study design</h4>This population-based cohort study used Massachusetts 2007-2009 birth certificates linked to 2007-2010 hospital discharge data. Access ...[more]

PMID: 31431409

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Project description:BackgroundCongenital cytomegalovirus (cCMV) infection can have a broad range of manifestations. This study aimed to assess cCMV-associated sequelae and healthcare resource utilization (HCRU) in infants during the first year of life in Germany.MethodsA retrospective, controlled cohort study using German claims data from the Institute for Applied Health Research Berlin (InGef) database was conducted. cCMV-associated sequelae and HCRU during the first year of life were assessed by matching (1:60) infants with at least one inpatient/outpatient cCMV diagnosis (ICD-10-GM: P35.1) ≤90 days after birth (cCMV90 cohort) and infants with at least one inpatient cCMV diagnosis plus specific sequelae ≤21 days after birth (cCMV21-S) to infants without cCMV or CMV (ICD-10-GM: B25) diagnosis (control group), respectively. Outcomes were analyzed during the first 365 days of life.ResultsBetween 2014-2018, we identified 54 newborns for cCMV90 and 24 newborns for cCMV21-S cohort. Compared to the 3,240 and 1,440 controls, respectively, more cCMV90 infants (83.3% vs. 41.9%, p<0.01) presented with at least one sequela during the first year of life, including intrauterine growth retardation (42.6% vs. 5.3%, p<0.01), sensorineural hearing loss (SNHL) to deafness (38.9% vs. 2.2%, p<0.01), and motor development disorders (33.3% vs. 10.9%, p<0.01). Further, 13.0% of cCMV90 infants (vs. 2.3%, p<0.01) suffered from visual impairment. In cCMV21-S cohort, intrauterine growth retardation (79.2% vs. 6.0%, p<0.01), prematurity (54.2% vs. 7.3%, p<0.01), and motor development disorders (50.0% vs. 11.0%, p<0.01) were the most frequent sequelae. Infants in the cCMV90 and cCMV21-S cohort had, on average, 7.3 times and 9.5 times more hospitalizations and 2.0 times and 2.1 times more outpatient physician visits than their respective controls (p<0.01). Hospitalized infants with cCMV stayed, on average, significantly longer in hospital compared to their controls (cCMV90 cohort: 30.3 days vs. 9.0 days, p<0.01; cCMV21-S cohort: 46.5 days vs. 9.3 days, p<0.01).ConclusionscCMV-infection shows a considerable disease and healthcare burden during the first year of life. More than 80% of the identified newborns with cCMV suffered from at least one associated sequela during the first year of life, including long-term sequelae such as SNHL (40%) and visual impairment (13%). Additional steps for prevention of cCMV infection and associated sequelae as well as a comprehensive monitoring of disease burden are needed.

Dataset Information

Emergency department utilization during the first year of life among infants born to women at risk of disability.

Background

Objectives

Study design

Results

Conclusion

Publications

Emergency department utilization during the first year of life among infants born to women at risk of disability.

Similar Datasets

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