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Objective <p>To characterize relationships between social determinants of health (SDoH) and mortality among infants receiving extracorporeal membrane oxygenation (ECMO).</p> Study design <p>Retrospectively, we identified infants born &gt;34weeks gestation and &gt;1.8 kilograms who received ECMO from 2010-2022. The primary predictor was the child opportunity index (COI). The outcome was in-NICU mortality. Due to interactions between SDoH and diagnoses, the main analyses were performed within the diagnostic cohort using multilevel socioecological factors.</p> Results <p>Overall, 2254 neonates received ECMO [congenital diaphragmatic hernia (32%, CDH), meconium aspiration syndrome (27%, MAS), cardiac (13%) and other (28%, e.g., sepsis)]. Characteristics differed with MAS more common in lower COI and Black race, while CDH was more common in the White race. COI and maternal race/ethnicity were unrelated to in-NICU mortality.</p> Conclusion <p>Despite epidemiological differences by SDoH, the primary outcome was consistent across groups, suggesting potential resilience to social risk factors and underscoring the importance of studying distinct cohorts separately.</p>

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Neonatal extracorporeal membrane oxygenation outcomes according to social determinants of health

  • 期刊论文

  • 发表日期：

    2026年4月29日

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  • Swati Chandhoke,
  • Isabella Zaniletti,
  • Robert DiGeronimo,
  • Shannon E. G. Hamrick,
  • Karna Murthy,
  • Michael A. Padula,
  • Natalie E. Rintoul,
  • Theresa R. Grover,
  • Philip T. Levy,
  • Katie M. Moynihan,
  • Zeenia Billimoria,
  • Nicholas Carr,
  • Jeanne Carroll,
  • Rachel Chapman,
  • James Connelly,
  • John Daniel,
  • Vedanta Dariya,
  • Robert DiGeronimo,
  • Dan Dirnberger,
  • Michelle Elias Ruiz,
  • Jason Gien,
  • Sharada Gowda,
  • Brian Gray,
  • Pam Griffiths,
  • Theresa Grover,
  • Shannon Hamrick,
  • John Ibrahim,
  • Sarah Keene,
  • Katrin Lichtsinn,
  • Leslie Lusk,
  • Burhan Mahmood,
  • Abhishek Makkar,
  • Franscesca Miquel-Verges,
  • Tasnim Najaf,
  • Samantha O’Neill,
  • Vilmaris Quinones,
  • Rakesh Rao,
  • Natalie Rintoul,
  • Rick Rodriguez,
  • Ruth Seabrook,
  • Jeff Shenberger,
  • Patrick Sloan,
  • Denise Suttner,
  • Melissa Tyree,
  • Susan Williams,
  • Sushmita Yallapragada,
  • Sandy Johng

摘要

Objective

To characterize relationships between social determinants of health (SDoH) and mortality among infants receiving extracorporeal membrane oxygenation (ECMO).

Study design

Retrospectively, we identified infants born >34weeks gestation and >1.8 kilograms who received ECMO from 2010-2022. The primary predictor was the child opportunity index (COI). The outcome was in-NICU mortality. Due to interactions between SDoH and diagnoses, the main analyses were performed within the diagnostic cohort using multilevel socioecological factors.

Results

Overall, 2254 neonates received ECMO [congenital diaphragmatic hernia (32%, CDH), meconium aspiration syndrome (27%, MAS), cardiac (13%) and other (28%, e.g., sepsis)]. Characteristics differed with MAS more common in lower COI and Black race, while CDH was more common in the White race. COI and maternal race/ethnicity were unrelated to in-NICU mortality.

Conclusion

Despite epidemiological differences by SDoH, the primary outcome was consistent across groups, suggesting potential resilience to social risk factors and underscoring the importance of studying distinct cohorts separately.