Socioeconomic status and injury risk in children

Research has consistently shown that low socioeconomic status (SES) is associated with an increased risk of poor health and death in adults and children. Studies from around the world have shown an inverse relationship between SES and childhood injury morbidity and mortality. For example, compared with children with high SES, children with low SES are at an increased risk of death from pedestrian collisions, fires, falls and drownings, and at an increased risk of hospitalization from recreation or play injuries. Research from England and Wales shows that these disparities in mortality between high and low SES children may be widening over time. This paper provides an overview of the literature on the relationship between SES and childhood injury morbidity and mortality, outlines the postulated mechanisms for this relationship, and highlights some intervention studies targeted to low SES children.     

Neonatal sepsis as a risk factor for neurodevelopmental changes in preterm infants with very low birth weight

Objectiveto evaluate neonatal sepsis as a risk factor for abnormal neuromotor and cognitive development in very low birth weight preterm infants at 12 months of corrected age.Methodsthis was a prospective cohort study that followed the neuromotor and cognitive development of 194 very low birth weight preterm infants discharged from a public neonatal intensive care unit. The Bayley Scale of Infant Development (second edition) at 12 months of corrected age was used. The outcomes were the results of the clinical/neurological evaluation and the scores of the psychomotor development index (PDI) and mental development index (MDI) of the Bayley Scale of Infant Development II. The association between neonatal sepsis and neuromotor development and between neonatal sepsis and cognitive development was verified by logistic regression analysis.Resultsmean birth weight was 1,119 g (SD: 247) and mean gestational age was 29 weeks and 6 days (SD: 2). Approximately 44.3%(n = 86) of the infants had neonatal sepsis and 40.7% (n = 79) had abnormal neuromotor development and/or abnormal psychomotor development index (PDI < 85) at 12 months of corrected age. On the mental scale, 76 (39.1%) children presented abnormal cognitive development (MDI < 85). Children with neonatal sepsis were 2.5 times more likely to develop changes in neuromotor development (OR: 2.50; CI: 1.23‐5.10). There was no association between neonatal sepsis and cognitive development impairment.Conclusionneonatal sepsis was an independent risk factor for neuromotor development impairment at 12 months of corrected age, but not for mental development impairment.