Associations of Newborn Social Risk Factors With High Infant Weight-for-Length at Age 6 Months: Observational Clinical Cohort

Abstract

Objective: This study aimed to quantify associations between newborn social risk factors and high infant weight-for-length (WFL) at 6 months. Methods: We conducted a longitudinal, observational study using electronic health record data among infants in New York City. We included newborns with a primary care screening questionnaire for social risk factors (food insecurity, housing instability, transportation problems, and utility hardship) measured using the Accountable Health Communities Screening Tool. We conducted regression analyses to assess associations between social risk factors and high WFL, or the 97.7th percentile at 6 months. Secondary analyses included additional single-time-point and longitudinal weight outcomes (continuous and dichotomous). Results: Among 1876 newborns, 77.3% identified as Hispanic/Latino, almost all had Medicaid insurance (96.6%), 355 (23.3%) had food insecurity risk, 149 (7.9%) had housing instability, 132 (7.0%) had transportation problems, and 110 (5.9%) had utility hardship. Newborns with utility hardship had higher odds of high WFL in unadjusted (OR 3.0, 95% CI: 1.8-5.2) and adjusted models (aOR 3.1, 95% CI: 1.7-5.6) accounting for infant, parent, and social risk factors. Conclusions: Newborn utility hardship was associated with obesity risk at age 6 months. Interventions to address newborn social risk factors should examine the effectiveness of utility shutoff protection to reduce excess infant weight gain.