Associations of Community Material Neighborhood Deprivation With the Diagnosis of Asthma Among Infants With Bronchopulmonary Dysplasia (BPD)

OBJECTIVE: To quantify associations of the community-level material deprivation index (CMDI) with asthma diagnosis by age 5 years among preterm infants with bronchopulmonary dysplasia (BPD). METHODS: We conducted a retrospective cohort study of preterm infants with BPD, born between 2010 and 2019, discharged from a single hospital system to a home address in the Philadelphia metropolitan area, with documented follow-up in the Children's Hospital of Philadelphia Care Network through 5 years of age. Patient charts were reviewed for asthma diagnoses, identified by ICD-10 codes. We geocoded each patient's address at time of neonatal intensive care unit (NICU) discharge to assign census tract CMDI values (range 0 to 1). Multivariable logistic regression models quantified associations of CMDI with asthma diagnosis by age 5 adjusting for patient-level factors. RESULTS: Of the 337 preterm infants with BPD and 5-year follow-up within the CHOP Care Network, 169 (50%) were diagnosed with asthma by age 5. CMDI was higher among infants diagnosed with asthma compared to those without asthma (0.43 vs 0.38, p = 0.002). Per standard deviation increment of CMDI, infants had 34% and 32% higher odds of asthma diagnosis in unadjusted (OR 1.34, 95% CI: 1.11, 1.62) and adjusted (aOR 1.32, 95%CI: 1.05-1.65) models, respectively. CONCLUSIONS: Among an urban population of former preterm infants with BPD, high rates of asthma by school age were noted and higher neighborhood deprivation was associated with asthma diagnosis by age 5 years.