656 - Navigating the Journey Home: The Impact of Social Determinants of Health on Length of Stay for Neonates Discharged with Feeding Support from the Neonatal Intensive Care Unit (NICU)

Publication Number: 4642.656

Claire Hockett, McGovern Medical School - - Houston, TX, Houston, TX, United States; Jaclyn Ruggiero, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States; Sepideh Saroukhani, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States; Allison Davidson, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States

Background: Increasing numbers of infants are discharged from the Neonatal Intensive Care Unit (NICU) with durable medical equipment, including feeding support. Families of these technology-dependent infants face unique challenges as they transition home and assume full responsibility for their child’s complex medical needs. These challenges may be intensified when infants experience longer NICU stays, which increase both medical complications and financial strain.

Objective: This study aimed to identify factors associated with length of stay (LOS) among infants discharged from the NICU with feeding equipment, with a focus on the role of Social Determinants of Health (SDoH).

Design/Methods: A retrospective chart review was conducted for neonates discharged home on feeding support between January 2018 and April 2024 from the Children’s Memorial Hermann Hospital (CMHH) level IV NICU. Maternal demographics and neonatal characteristics were collected and analyzed. Associations between these factors and LOS were evaluated using descriptive and regression analyses.

Results: A total of 323 neonates were included. The mean LOS was 91.7 days. Illness severity did not differ by gender, inborn versus out born status, or race. Black/African American race (p=0.016) was the only factor that was related to longer LOS. Maternal age 20-29 years (p=0.016) or over 40 years (p=0.039) and parity of one (p=0.003) were associated with shorter LOS. No other demographic variables were associated with statistically significant differences in LOS.

Conclusion(s): Both neonatal and maternal factors influence LOS for infants discharged with feeding support. The association between longer LOS and certain maternal demographic characteristics, particularly Black/African American race, highlights the need for further investigation to understand underlying causes and guide interventions aimed at improving equity and reducing disparities in neonatal care.