Health Care Utilization During the COVID-19 Pandemic Among Individuals Born Preterm

Medientyp: E-Artikel
Titel: Health Care Utilization During the COVID-19 Pandemic Among Individuals Born Preterm
Beteiligte: McGowan, Elisabeth C.; McGrath, Monica; Law, Andrew; O’Shea, T. Michael; Aschner, Judy L.; Blackwell, Courtney K.; Fry, Rebecca C.; Ganiban, Jody M.; Higgins, Rosemary; Margolis, Amy; Sathyanarayana, Sheela; Taylor, Genevieve; Alshawabkeh, Akram N.; Cordero, José F.; Spillane, Nicole T.; Hudak, Mark L.; Camargo, Carlos A.; Dabelea, Dana; Dunlop, Anne L.; Elliott, Amy J.; Ferrara, Assiamira M.; Talavera-Barber, Maria; Singh, Anne Marie; Karagas, Margaret R.; [...]
Erschienen: American Medical Association (AMA), 2023
Erschienen in: JAMA Network Open
Sprache: Englisch
DOI: 10.1001/jamanetworkopen.2023.10696
ISSN: 2574-3805
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Beschreibung: <jats:sec id="ab-zoi230338-4"><jats:title>Importance</jats:title><jats:p>Limited data exist on pediatric health care utilization during the COVID-19 pandemic among children and young adults born preterm.</jats:p></jats:sec><jats:sec id="ab-zoi230338-5"><jats:title>Objective</jats:title><jats:p>To investigate differences in health care use related to COVID-19 concerns during the pandemic among children and young adults born preterm vs those born at term.</jats:p></jats:sec><jats:sec id="ab-zoi230338-6"><jats:title>Design, Setting, and Participants</jats:title><jats:p>In this cohort study, questionnaires regarding COVID-19 and health care utilization were completed by 1691 mother-offspring pairs from 42 pediatric cohorts in the National Institutes of Health Environmental Influences on Child Health Outcomes Program. Children and young adults (ages 1-18 years) in these analyses were born between 2003 and 2021. Data were recorded by the August 31, 2021, data-lock date and were analyzed between October 2021 and October 2022.</jats:p></jats:sec><jats:sec id="ab-zoi230338-7"><jats:title>Exposures</jats:title><jats:p>Premature birth (&amp;lt;37 weeks’ gestation).</jats:p></jats:sec><jats:sec id="ab-zoi230338-8"><jats:title>Main Outcomes and Measures</jats:title><jats:p>The main outcome was health care utilization related to COVID-19 concerns (hospitalization, in-person clinic or emergency department visit, phone or telehealth evaluations). Individuals born preterm vs term (≥37 weeks’ gestation) and differences among preterm subgroups of individuals (&amp;lt;28 weeks’, 28-36 weeks’ vs ≥37 weeks’ gestation) were assessed. Generalized estimating equations assessed population odds for health care used and related symptoms, controlling for maternal age, education, and psychiatric disorder; offspring history of bronchopulmonary dysplasia (BPD) or asthma; and timing and age at COVID-19 questionnaire completion.</jats:p></jats:sec><jats:sec id="ab-zoi230338-9"><jats:title>Results</jats:title><jats:p>Data from 1691 children and young adults were analyzed; among 270 individuals born preterm, the mean (SD) age at survey completion was 8.8 (4.4) years, 151 (55.9%) were male, and 193 (71.5%) had a history of BPD or asthma diagnosis. Among 1421 comparison individuals with term birth, the mean (SD) age at survey completion was 8.4 (2.4) years, 749 (52.7%) were male, and 233 (16.4%) had a history of BPD or asthma. Preterm subgroups included 159 individuals (58.5%) born at less than 28 weeks’ gestation. In adjusted analyses, individuals born preterm had a significantly higher odds of health care utilization related to COVID-19 concerns (adjusted odds ratio [aOR], 1.70; 95% CI, 1.21-2.38) compared with term-born individuals; similar differences were also seen for the subgroup of individuals born at less than 28 weeks’ gestation (aOR, 2.15; 95% CI, 1.40-3.29). Maternal history of a psychiatric disorder was a significant covariate associated with health care utilization for all individuals (aOR, 1.44; 95% CI, 1.17-1.78).</jats:p></jats:sec><jats:sec id="ab-zoi230338-10"><jats:title>Conclusions and Relevance</jats:title><jats:p>These findings suggest that during the COVID-19 pandemic, children and young adults born preterm were more likely to have used health care related to COVID-19 concerns compared with their term-born peers, independent of a history of BPD or asthma. Further exploration of factors associated with COVID-19–related health care use may facilitate refinement of care models.</jats:p></jats:sec>
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