Implications of racial/ethnic perinatal health inequities on long-term neurodevelopmental outcomes and health services utilization

Infants born preterm and with low birth weight have increased risk for neurodevelopmental challenges later in life compared to term-born peers. These include functional motor impairment, cognitive and speech delays, neurobehavioral disorders, and atypical social development. There are well-documented inequities in the population distributions of preterm birth and associated short-term morbidities by race, ethnicity, language, and nativity. Far less is known about how these inequities affect long-term outcomes, though the impact of unequal access to post-discharge support services for preterm infants raises concerns about widening gaps in health, development, and functioning. In this review, we describe what is currently known about the impact of race, ethnicity, nativity, and language on long-term outcomes. We provide a framework for understanding inequities in social, political, and historical context. And we offer guidance for next steps to delineate mechanistic pathways and to identify interventions to eliminate inequities in long-term neurodevelopmental outcomes through research, intervention, and advocacy. (c) 2022 Elsevier Inc. All rights reserved.

Automated summary

Infants born preterm and with low birth weight are at greater risk for long-term neurodevelopmental challenges compared to term-born peers. Inequities in preterm birth rates and short-term morbidities based on race, ethnicity, language, and nativity have been well-documented. However, there is limited understanding of how these inequities impact long-term outcomes, although concerns have been raised about unequal access to post-discharge support services for preterm infants. This review provides an overview of the current knowledge on the impact of race, ethnicity, nativity, and language on long-term outcomes, and offers guidance for future research, intervention, and advocacy to address inequities in neurodevelopmental outcomes.