Development of Perinatal Social Determinants of Health Composite Risk Score in Infants Born Preterm
Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: To develop and validate a perinatal social determinants of health (SDoH) risk score for predicting neurodevelopmental outcomes in infants born preterm. STUDY DESIGN: This is a prospective cohort study of 395 infants born at ≤32 weeks' gestation recruited from 5 level III/IV neonatal intensive care units in Greater Cincinnati (2016-2019); 328 (83%) infants with complete data were analyzed. Five prenatal social risk factors-maternal age, education, household income, employment, and family structure-were combined into composite SDoH scores using supervised and unsupervised machine learning. The outcomes were Bayley Scales of Infant and Toddler Development, Third Edition, cognitive, language, and motor composite scores at 2 years corrected age; neurodevelopmental impairment was defined as ≥1 subscale <85. RESULTS: = 0.20 (SD = 0.14) of cognitive variance. Infants in the highest risk tertile scored 13.1 points lower in cognition than those in the lowest risk tertile, with similar gradients for language (19 points) and motor outcomes (7.8 points). Cross domain consistency was high (r = 0.97-1.00). Temporal validation at the age of 5 (n = 291) showed correlations of 0.33-0.35 with general cognitive ability (all P < .001). Discrimination for impairment was moderate (area under the curve, 0.67-0.68). CONCLUSIONS: This validated perinatal SDoH score quantifies cumulative social disadvantage in infants born preterm and supports early identification, targeted intervention, and standardized case-mix adjustment across neonatal intensive care units.
Source: The Journal of Pediatrics
Authors: Abiot Y. Derbie, Mekibib Altaye, Alonzo T. Folger, Nehal A. Parikh, Armin Allahverdy, Mekibib Altaye, Anita Arnsperger, Traci Beiersdorfer, Kaley Bridgewater, William Brinkman, Tanya Cahill, Mary Deneka, Abiot Derbie, Kent Dietrich, Christen Distler, Juanita Dudley, Abigail Evans, Jakayla Fulwood, Brianne Georg, Meredith Glover, Cathy Grisby, Lacey Haas, Karen Harpster, Lili He, Scott K. Holland, V.S. Priyanka Illapani, Anika Joshi, Kristin Kirker, Julia E. Kline, Beth M. Kline-Fath, Hailong Li, Matt Lanier, Melissa Marchetti, Stephanie L. Merhar, Greg Muthig, David Russell, Sara Stacey, Kari Tepe, Leanne Tamm, Katie Taylor, Julia Thompson, Jean A. Tkach, Sanjana Velu, Hui Wang, Jinghua Wang, Junqi Wang, Brynne Williams, Kelsey Wineland, Sandra Wuertz, Donna Wuest, Weihong Yuan
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,570
OpenAlex ID: W7204531589