# Determinants of Newborn Health and Health Care Trajectories in the First Year of Life

> **NIH NIH R01** · DARTMOUTH COLLEGE · 2022 · $676,866

## Abstract

PROJECT SUMMARY/ABSTRACT
Newborn health has improved in the United States in recent decades yet still lags that of other high-income
countries. A critically important yet understudied reason for this disappointing gap is the nature of the inpatient
care received by newborns and the effects this has on health during the first year of life. Neonatal care and
outcomes have been shown to vary markedly from hospital to hospital and between neonatal intensive care
units (NICUs), yet little is known about the causes and consequences of this variation, particularly for lower-risk
(e.g., less premature) newborns, who occupy most NICU beds today; few studies have examined how widely
differing patterns of care are linked to post-discharge outcomes. Our long-term goal is to extend our previous
descriptive studies of newborn-care variation to investigate and identify the temporal sequence of risk, medical
care, and outcomes through the first year of life. We will do so using a population-based cohort of 1.13 million
Medicaid-insured Texas newborns (54% of Texas births, 1 in 18 of US births). This unique dataset, developed
by members of our team, links maternal and newborn Medicaid claims/encounters to natality and mortality
records. Our central hypothesis is that newborn care, and subsequent infant health outcomes, are strongly
associated with specific, modifiable aspects of newborn and post-discharge care. We will study five gestational
age singleton cohorts: (1) very preterm, (2) moderately preterm, (3) early preterm, (4) early term, and (5) term.
In Aim 1, we will investigate the association of neonatal hospital care with hospital characteristics. We will then
test the association of these care patterns with mortality and morbidity (severe conditions, readmissions, and
ER use) during the inpatient period plus 7 days post-discharge. In Aim 2, the observation period is extended to
one-year post-discharge, with additional outcomes such as infant diagnoses derived from claims and multiple
weight measurements obtained from the Women, Infants, and Children Nutritional Program. We will test
associations of these risk-adjusted outcomes with birth-hospital characteristics, neonatal care, and post-
neonatal care. In Aim 3, we investigate the possible amplifying effects of hospital-level maternal race and
ethnicity composition on the foregoing analyses. This project will significantly advance our knowledge of
newborn care and outcomes for a large, diverse total birth cohort through the first year of life, providing
detailed information about determinants of early health. The findings will create actionable opportunities to
improve perinatal care delivery through policy development and new clinical improvement initiatives.

## Key facts

- **NIH application ID:** 10428462
- **Project number:** 5R01HD101523-02
- **Recipient organization:** DARTMOUTH COLLEGE
- **Principal Investigator:** DAVID C. GOODMAN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $676,866
- **Award type:** 5
- **Project period:** 2021-06-14 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10428462

## Citation

> US National Institutes of Health, RePORTER application 10428462, Determinants of Newborn Health and Health Care Trajectories in the First Year of Life (5R01HD101523-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10428462. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*