Preferred Parental Language and Neurodevelopmental Outcomes Among Infants With Acute Provoked Neonatal Seizures in the United States

Background: Parental non-English language preference (NELP) is associated with worse pediatric health outcomes. However, little is known about its relationship with developmental outcomes in infants with neonatal seizures. This study evaluated the relationship between parental NELP and neurodevelopment in a multicenter cohort of infants with neonatal seizures. Methods: Infants in the Neonatal Seizure Registry-II were included. Parental NELP was defined by the use of a professional interpreter for research consent and survey completion. The Warner Initial Developmental Evaluation of Adaptive and Functional Skills (WIDEA-FS) assessment was conducted at age 24 months. Multivariate regression was used to examine the association between parental NELP and WIDEA-FS. Functional developmental impairment was defined as a WIDEA-FS score 2 S.D.s below the normative mean. Results: Among 270 infants with neonatal seizures, 15 (6%) had parental NELP. Children with parental NELP had a WIDEA-FS score that was on average 13 points lower than that of infants without parental NELP (95% confidence interval [CI]: −27 to 1, P = 0.08) and over five times the odds of functional developmental impairment (odds ratio 4.9, 95% CI: 1.3 to 18.4, P = 0.017). Conclusions: Children with parental NELP were more likely to have functional developmental impairment at age 24 months when compared with children without parental NELP. Since parental NELP does not have a biologically plausible impact on neurodevelopment it likely reflects discriminatory experiences that affect developmental opportunities. These findings highlight the importance of identifying social drivers to decrease potential gaps in neurodevelopmental attainment for children with parental NELP.