# Impact of Neighborhood Disadvantage on Gastrointestinal Morbidity in Extremely Low Birthweight Infants

## TL;DR

Babies born with very low weight from disadvantaged neighborhoods are more likely to develop a serious gut condition, especially Black infants.

## Contribution

This study links neighborhood disadvantage and race to higher rates of necrotizing enterocolitis in extremely low birthweight infants.

## Key findings

- Infants with NEC had significantly higher area deprivation index scores than those without NEC.
- No Black infants in the least disadvantaged deciles were diagnosed with NEC.
- Neighborhood disadvantage is associated with increased gastrointestinal morbidity in ELBW infants.

## Abstract

Introduction: Necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP) are major causes of morbidity and mortality in extremely low birth weight (ELBW) infants. Social determinants of health (SDH) are associated with disparate outcomes for neonates admitted to the neonatal intensive care unit (NICU). This study sought to identify correlations between NEC, SIP, and SDH.

Methods: Retrospective cohort study of infants born between 22 and 25 weeks of gestation between 2017 and 2023. Utilizing the area deprivation index (ADI) as a marker for social vulnerability.

Results: The study included 156 patients. Infants with NEC had a statistically significant median ADI score (indicating more disadvantage) compared to those without NEC. No Black infants in the least disadvantaged deciles were diagnosed with NEC.

Conclusion: Babies from more disadvantaged backgrounds are more likely to develop NEC. This is even more pronounced in Black infants. Further investigation could lead to a more tailored feeding protocol to promote health equity.