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Am J Perinatol
DOI: 10.1055/a-2817-3566
Original Article

Neurodevelopmental Care Utilization among Preterm Infants in the Military Health Care System

Authors

  • Amanda Banaag

    1   Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, United States
    2   Department of Preventive Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States
    3   Center for Health Services Research, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States

  • Zachary Weber

    4   Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, Maryland, United States
    5   Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States

  • Caitlin Drumm 

    5   Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States

  • Genesis James

    4   Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, Maryland, United States

  • Tracey Koehlmoos

    2   Department of Preventive Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States
    3   Center for Health Services Research, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States

  • Rasheda Vereen 

    5   Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States

Funding Information This work was conducted with the Center for Health Services Research and funded by the Department of Defense, Defense Health Agency, grant number HU00012420022. The funding agency played no role in the design, analysis, or interpretation of findings.
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Abstract

Objective

This study aims to evaluate variation in neurodevelopmental care utilization in the Military Health System (MHS) for preterm infants.

Study Design

Retrospective cohort study of infants born preterm within the MHS from 2017 to 2021. Preterm birth was categorized as extreme preterm, very preterm, moderate preterm, late preterm, or unknown. Patient demographics were extracted. The primary outcome was the use of neurodevelopmental care within 2 years of birth.

Results

Compared with late preterm births, total use of specialty care was significantly higher (p < 0.05) in moderate, very, and extreme preterm births. Black infants had fewer total visits than White infants (−1.54, p < 0.05). Disparities by region of birth were noted, with lower utilization in the Pacific and West South-Central census divisions (p < 0.05).

Conclusion

There are differences in neurodevelopmental care utilization among preterm infants in the MHS, driven by gestational age, race, and geography. These findings support the need for a standardized policy on neurodevelopmental follow-up.

Key Points

  • Neurodevelopmental utilization varies by sociodemographic factors.

  • Despite universal access to care, neurodevelopmental care utilization varies in the military health care system.

  • Standardized neurodevelopmental follow-up is needed to ensure equitable access to care.

Keywords

premature infants - neurodevelopmental disorders - health services - health disparities

Data Availability Statement

The data that support the findings of this study are available from the United States Defense Health Agency. Restrictions apply to the availability of these data, which were used under Federal Data User Agreements for the current study, and so are not publicly available.


Contributors' Statement

A.B.: Data curation, formal analysis, funding acquisition, investigation, methodology, resources, software, writing–original draft, writing–review and editing. Z.W.: Conceptualization, data curation, formal analysis, methodology, resources, validation, writing–review and editing. C.D.: Conceptualization, data curation, methodology, visualization, writing–review and editing. G.J.: Conceptualization, investigation, writing–original draft. T.K.: Funding acquisition, methodology, project administration, software, supervision, writing–review and editing. R.V.: Conceptualization, data curation, formal analysis, investigation, methodology, project administration, resources, supervision, validation, visualization, writing–original draft, writing–review and editing.


Ethical Approval

This study received an exempt determination from the Institutional Review Board at the Uniformed Services University of the Health Sciences.


Note

The contents of this publication are the sole responsibility of the authors and do not necessarily reflect the views, assertions, opinions or policies of the Uniformed Services University of the Health Sciences (USUHS), the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. (HJF), the Department of Defense, or the Departments of the Army, Navy, or Air Force. Mention of trade names, commercial products, or organizations does not imply endorsement by the U.S. Government.


Supplementary Material



Publication History

Received: 16 December 2025

Accepted: 18 February 2026

Article published online:
02 March 2026

© 2026. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
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