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

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.