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. 2025 Jun 27;17(6):e86856.
doi: 10.7759/cureus.86856. eCollection 2025 Jun.

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

Samantha Shaffer  1 , Katie A Huff  2 , James Slaven  3 , Seethal A Jacob  4   5 , Jason Z Niehaus  2
Affiliations

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

Samantha Shaffer et al. Cureus. .

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.

Keywords: extremely low birthweight infant; necrotizing enterocolitis; nicu; prematurity; social determinants of health.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: Riley Children's Foundation grant through the Division of Neonatology Pilot Fund paid for statistical support for this project. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

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