{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T14:22:25Z","timestamp":1789827745234,"version":"4.0.1"},"reference-count":47,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi230338-4\"><jats:title>Importance<\/jats:title><jats:p>Limited data exist on pediatric health care utilization during the COVID-19 pandemic among children and young adults born preterm.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230338-5\"><jats:title>Objective<\/jats:title><jats:p>To investigate differences in health care use related to COVID-19 concerns during the pandemic among children and young adults born preterm vs those born at term.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230338-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>In this cohort study, questionnaires regarding COVID-19 and health care utilization were completed by 1691 mother-offspring pairs from 42 pediatric cohorts in the National Institutes of Health Environmental Influences on Child Health Outcomes Program. Children and young adults (ages 1-18 years) in these analyses were born between 2003 and 2021. Data were recorded by the August 31, 2021, data-lock date and were analyzed between October 2021 and October 2022.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230338-7\"><jats:title>Exposures<\/jats:title><jats:p>Premature birth (&amp;amp;lt;37 weeks\u2019 gestation).<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230338-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The main outcome was health care utilization related to COVID-19 concerns (hospitalization, in-person clinic or emergency department visit, phone or telehealth evaluations). Individuals born preterm vs term (\u226537 weeks\u2019 gestation) and differences among preterm subgroups of individuals (&amp;amp;lt;28 weeks\u2019, 28-36 weeks\u2019 vs \u226537 weeks\u2019 gestation) were assessed. Generalized estimating equations assessed population odds for health care used and related symptoms, controlling for maternal age, education, and psychiatric disorder; offspring history of bronchopulmonary dysplasia (BPD) or asthma; and timing and age at COVID-19 questionnaire completion.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230338-9\"><jats:title>Results<\/jats:title><jats:p>Data from 1691 children and young adults were analyzed; among 270 individuals born preterm, the mean (SD) age at survey completion was 8.8 (4.4) years, 151 (55.9%) were male, and 193 (71.5%) had a history of BPD or asthma diagnosis. Among 1421 comparison individuals with term birth, the mean (SD) age at survey completion was 8.4 (2.4) years, 749 (52.7%) were male, and 233 (16.4%) had a history of BPD or asthma. Preterm subgroups included 159 individuals (58.5%) born at less than 28 weeks\u2019 gestation. In adjusted analyses, individuals born preterm had a significantly higher odds of health care utilization related to COVID-19 concerns (adjusted odds ratio [aOR], 1.70; 95% CI, 1.21-2.38) compared with term-born individuals; similar differences were also seen for the subgroup of individuals born at less than 28 weeks\u2019 gestation (aOR, 2.15; 95% CI, 1.40-3.29). Maternal history of a psychiatric disorder was a significant covariate associated with health care utilization for all individuals (aOR, 1.44; 95% CI, 1.17-1.78).<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230338-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>These findings suggest that during the COVID-19 pandemic, children and young adults born preterm were more likely to have used health care related to COVID-19 concerns compared with their term-born peers, independent of a history of BPD or asthma. Further exploration of factors associated with COVID-19\u2013related health care use may facilitate refinement of care models.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.10696","type":"journal-article","created":{"date-parts":[[2023,4,28]],"date-time":"2023-04-28T11:34:00Z","timestamp":1682681640000},"page":"e2310696","source":"Crossref","is-referenced-by-count":9,"title":["Health Care Utilization During the COVID-19 Pandemic Among Individuals Born Preterm"],"prefix":"10.1001","volume":"6","author":[{"given":"Elisabeth C.","family":"McGowan","sequence":"first","affiliation":[{"name":"The Warren Alpert School of Medicine, Brown University, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"McGrath","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Law","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. Michael","family":"O\u2019Shea","sequence":"additional","affiliation":[{"name":"The University of North Carolina at Chapel Hill, Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy L.","family":"Aschner","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine, New York, New York"},{"name":"Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney K.","family":"Blackwell","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca C.","family":"Fry","sequence":"additional","affiliation":[{"name":"The University of North Carolina at Chapel Hill, Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jody M.","family":"Ganiban","sequence":"additional","affiliation":[{"name":"George Washington University, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosemary","family":"Higgins","sequence":"additional","affiliation":[{"name":"Department of Global and Community Health, College of Health and Human Sciences, George Mason University, Fort Myers, Florida"},{"name":"Marieb College of Health and Human Services, Florida Gulf Coast University, Fort Myers"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Margolis","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheela","family":"Sathyanarayana","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle"},{"name":"Seattle Children\u2019s Research Institute, Seattle, 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