P1.191: The Impact of Language Preference other than English on NICU Outcomes

Background: The population with language preferences other than English (LPOE) in the United States has grown from 14 million in 1990 to 25.7 million in 2021, with regional variations such as 9% in Massachusetts. LPOE hinders healthcare access, leading to less prenatal care, fewer screenings, and lower health literacy, all of which impact health outcomes. While the effect of LPOE on pediatric outcomes has been documented, its impact on neonatal outcomes remains underexplored. We examined the association between LPOE families and hospital outcomes, including length of stay (LOS), social vulnerability index (SVI), and diagnoses in preterm infants admitted to a level III NICU between 2011 and 2023.

Methods: This retrospective analysis included all preterm infants born at a single-center level III NICU from 2011 to 2023. Demographic characteristics, diagnoses, and length of stay (LOS) were abstracted from electronic health records. Infants were categorized as LPOE if parents selected a language preference other than English or if interpreter use was noted in their medical record; all others were classified as English language preference (ELP). The Social Vulnerability Index (SVI) was determined based on the mother's ZIP code and categorized as high (≥0.5) or low ( < 0.5) vulnerability. Descriptive statistics were calculated, including frequencies and percentages for categorical variables and medians and standard deviations for continuous variables. Outcomes were compared using chi-squared test, Wilcoxon-Mann-Whitney, and logistic regression.

Results: We included 7,335 preterm infants, with 9.65% identified as LPOE (Table 1). After English, the most common languages were Spanish, Portuguese, and Mandarin Chinese. LPOE families were more likely to have a high vulnerability index (89.7% vs. 72.2%, p< 0.001). When comparing median LOS by gestational age (Fig 1), moderately and extremely preterm LPOE infants had significantly longer stays compared to ELP infants (26 days vs. 22 days and 105 days vs. 87 days, respectively, p< 0.05). LPOE was also associated with intraventricular hemorrhage (p=0.02) but not with other neonatal diagnosis

Conclusion: LPOE preterm infants are more likely to experience higher vulnerability and longer lengths of stay, particularly among extremely preterm infants, underscoring disparities in neonatal care. Our results demonstrate the need for targeted interventions to address the challenges LPOE families face in neonatal care settings.