Racial, Ethnic, and Socioeconomic Associations with Outcomes in Neonatal Hypoxic Ischemic Encephalopathy: A Retrospective Cohort Study

Neonatal hypoxic-ischemic encephalopathy (HIE) contributes to perinatal morbidity and mortality. The influence of racial, ethnic, and socioeconomic factors on long-term outcomes is not well understood. This single-center retrospective study examined associations between these factors and long-term neurodevelopment in infants with HIE. Demographic and clinical data were obtained via chart review. Racial and ethnic minority (REM) status was self-reported. Socioeconomic factors included Social Vulnerability Index (SVI) and insurance type. Motor and language delays were determined by physician assessment or standardized testing. Logistic regressions assessed associations between development, REM, and socioeconomic factors while controlling for clinical covariates. Among 211 infants, 117 (56%) were REM. Motor delay occurred in 49 (23%) and was not associated with REM, SVI, or insurance. Language delay occurred in 59 (28%) and was associated with REM status although the association lessened when insurance was included. These findings suggests that societal factors may underlie language developmental disparities after HIE.