title: Differential Effects of the Single-Family Room Neonatal Intensive Care Unit on 18- to 24-Month Bayley Scores of Preterm Infants.
abstract: To determine the effects of human milk and social/environmental disparities on developmental outcomes of infants born preterm cared for in a single-family room (SFR) neonatal intensive care unit (NICU).
  
  
  
  Outcomes were compared between infants weighing ?1250 g cared for in an open-bay NICU (1/2007-8/2009) (n?=?394) and an SFR NICU (1/2010-12/2011) (n?=?297). Human milk provision at 1 week, 4 weeks and discharge, and 4 week volume (mL/kg/day) were analyzed. At 18-24 months of age, the Bayley III was administered. Group differences were evaluated and multiple linear regression analyses were run.
  
  
  
  Infants cared for in the SFR NICU had higher Bayley III cognitive and language scores, higher rates of human milk provision at 1 and 4 weeks, and higher human milk volume at 4 weeks. In adjusted regression models, the SFR NICU was associated with a 2.55-point increase in Bayley cognitive scores and 3.70-point increase in language scores. Every 10?mL/kg/day increase of human milk at 4 weeks was independently associated with increases in Bayley cognitive, language, and motor scores (0.29, 0.34, and 0.24, respectively). Medicaid was associated with decreased cognitive (?4.11) and language (?3.26) scores, and low maternal education and non-white race with decreased language scores (?4.7 and ?5.8, respectively). Separate models by insurance status suggest there are differential benefits from SFR NICU and human milk between infants with Medicaid and private insurance.
  
  
  
  Infants born preterm cared for in the SFR NICU have higher Bayley language and cognitive scores and receive more human milk. Independent effects on outcomes were derived from SFR NICU, provision of human milk, and social and environmental factors.
authors.affiliation: Women & Infants Hospital of Rhode Island, Providence, RI; Alpert School of Medicine, Brown University, Providence, RI. Electronic address: bvohr@wihri.org.
authors.forename: Betty
authors.initials: B
authors.lastname: Vohr
authors.affiliation: Women & Infants Hospital of Rhode Island, Providence, RI; Alpert School of Medicine, Brown University, Providence, RI.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: McGowan
authors.affiliation: Women & Infants Hospital of Rhode Island, Providence, RI.
authors.forename: Leslie
authors.initials: L
authors.lastname: McKinley
authors.affiliation: Women & Infants Hospital of Rhode Island, Providence, RI.
authors.forename: Richard
authors.initials: R
authors.lastname: Tucker
authors.affiliation: Women & Infants Hospital of Rhode Island, Providence, RI; Alpert School of Medicine, Brown University, Providence, RI.
authors.forename: Lenore
authors.initials: L
authors.lastname: Keszler
authors.affiliation: Women & Infants Hospital of Rhode Island, Providence, RI.
authors.forename: Barbara
authors.initials: B
authors.lastname: Alksninis
mesh_terms: D000328:Adult; D001903:Bottle Feeding; D001942:Breast Feeding; D002657:Child Development; D002675:Child, Preschool; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006749:Hospital Design and Construction; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration*; D007902:Length of Stay; D008297:Male; D008484:Medicaid; D008895:Milk, Human; D010362:Patients' Rooms; D011446:Prospective Studies; D044469:Racial Groups; D014481:United States; D015430:Weight Gain
keywords: Medicaid; developmental outcomes; human milk; maternal education; single-family room NICU