Environmental Determinants of Post-Discharge Acute Respiratory Illness among Preterm Infants with Bronchopulmonary Dysplasia

• DOI: 10.3390/ijerph21050648
• Publication Date: 2024-05-20T15:06:41Z
• Authors: Jonathan J. Szeto; Joshua K. Radack; Sara B. DeMauro; Erik A. Jensen; Kathleen Gibbs; Nicolas P. Novick; Kristan A. Scott; Daria C. Murosko; Heather H. Burris; Timothy D. Nelin
• Keywords: Bronchopulmonary Dysplasia

Objective: To analyze the association of components Centers for Disease Control and Prevention (CDC) Environmental Justice Index (EJI) with respiratory health outcomes among infants bronchopulmonary dysplasia (BPD) within one year after discharge from neonatal intensive care unit. Methods: This was a retrospective cohort study preterm BPD. Multivariable logistic regression models estimated associations EJI its medically attended acute illness, defined as an ED visit or inpatient readmission, A mediation analysis conducted to evaluate how environmental injustice may contribute racial disparities in illness. Results: Greater associated increased risk illness (per standard deviation increment, aOR 1.38, 95% CI: 1.12–1.69). Of index’s components, Burden Module’s Air pollution domain had greatest (aOR 1.44, 1.44–2.61). With respect individual indicators EJI, Diesel Particulate Matter (DSLPM) Toxic Cancer Risk (ATCR) demonstrated strongest relationship 2.06, 1.57–2.71 2.10, 1.59–2.78, respectively). Among non-Hispanic Black infants, 63% experienced compared 18% White infants. DSLPM mediated 39% Black–White disparity (p = 0.004). Conclusions: exposures, particularly air pollution, are post-discharge BPD adjusting clinical, demographic, social vulnerability factors. Certain types pollutants, namely, DSLPM, more greatly exposures