Liv Ames for EdSource

Babies weighing less than 3.3 pounds at birth are at risk for a variety of neurological and developmental problems in childhood, yet 20 percent of these babies were not referred to California’s High Risk Infant Follow Up program, according to a study by Stanford University School of Medicine.

The study found that the larger and healthier of these babies, those born in smaller neonatal units, and African-American and Hispanic babies were less likely to be referred to the state follow-up program that provides diagnostic assessments and services until they turn 3.

The researchers assessed data on 10,433 very-low-birth-weight babies born in California during 2010 and 2011, soon after the state’s high-risk infant follow-up program was revamped.

“If we cannot succeed in that first step of getting these babies referred to follow-up, we’re at a critical disconnect for what we can offer them as they grow and develop,” said Dr. Susan Hintz, professor of neonatal and developmental medicine and lead author of the study.

California is ahead of other states in having a comprehensive, statewide program to help high-risk infants, Hintz said. “The expectation that all our high-risk infants will be referred is enormously innovative in this country,” she said.

The referral rate appears to have increased since 2011, Hintz said. Since then, there have been substantial improvements in online tools and resources available to hospitals, she said, and California Children’s Services was able to provide feedback to hospitals with low referral rates.

Hintz said the referral rates for low-volume hospitals averaged 65 percent compared to 85 percent for high-volume hospitals. A third of the state’s largest neonatal intensive care units have referral rates above 95 percent. “We can look at those sites to try to understand what allows them to be so successful,” Hintz said.

Hintz collaborated on the study with other Stanford researchers and with researchers from the California Perinatal Quality Care Collaborative and the California Department of Health Care Services. The study appears in the February issue of The Journal of Pediatrics, which was published online Jan. 22.



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