A27-01 Emergency Department Utilization of Moderate to Late Preterm Infants of Non-English-Speaking Parents

Abstract Rationale Moderate to late preterm (MLPT) infants (32–36 weeks’ gestation) comprise 84% of preterm births. While generally healthy, MLPT infants have higher rates of emergency department (ED) visits and re-hospitalization compared with term infants. For term infants, a non-English primary language is a known risk factor for ED use, but this has not been studied MLPT infants. This study examined the association between birth parent primary language and ED visits in the first two years among MLPT infants, including the role of interpreter services used during the delivery hospitalization. Methods Multicenter retrospective cohort study of MLPT infants born 2016–2021 within a single health system. Exclusions were infants who died, had congenital anomalies or genetic disorders, were lost to follow-up within 3 months, or lacked documented parental preferred language. ED visit data within in the health system were obtained from the electronic health record after IRB approval. For infants of non-English-speaking birthing parents, we further evaluated each chart for documentation of three types of interpreter interactions: 1. Interpreter used during birth admission, 2. Interpreter used for discharge instructions, and 3. After Visit Summary (AVS) printed in the birthing parent’s primary language. Data were summarized using descriptive statistics, then number of ED visits for MLPT infants of English and non-English-speaking birthing parents were evaluated via adjusted Poisson regression model. Results Among 3804 MLPT infants, 393 (10%) were born to non-English-speaking birthing parents. Tobacco use in pregnancy, neonatal intensive care unit (NICU) admission rate, and length of stay were higher in the English-speaking group (Table 1, p 0.05). The non-English-speaking group had 17% higher rate of ED visits compared with English-speaking group (Incidence Rate Ratio 1.17, 95% Confidence Interval 1.09-1.25, p 0.001). Among 393 infants in the non-English speaking group, 43 (11%) had all 3 interpreter interactions documented, while 111 (28%) had none. The least frequently used intervention was the AVS in the primary language, used for 96 patients (24%). ED visit rates trended higher for infants with fewer interpreter interactions compared with those exposed to all 3 services (p 0.05). Conclusions MLPT infants of non-English-speaking parents had higher rates of ED visits across the first 2 years of life compared with MLPT infants of English-speaking parents. Results suggest that greater exposure to interpreter services related to lower ED utilization. Interpreter documentation was inconsistent, highlighting targetable gaps in communication support for this vulnerable group of infants. This abstract is funded by: None