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Racial/Ethnic Disparities in Morbidity and Mortality for Preterm Neonates Admitted to a Tertiary Neonatal Intensive
Courtney Townsel1,2, Rebecca Keller3, Chia-Ling Kuo4
1Department of Obstetrics and Gynecology, University of Connecticut Health, Farmington, CT, USA. townsel@uchc.edu.
Journal of Racial and Ethnic Health Disparities
|October 27, 2017
Summary
In-hospital mortality did not differ by race/ethnicity in preterm infants. However, Black neonates had improved mortality, while respiratory distress syndrome and retinopathy of prematurity varied across racial groups.
Area of Science:
- Neonatal Intensive Care Unit (NICU) research
- Perinatal epidemiology
- Racial and ethnic disparities in healthcare
Background:
- Preterm neonates admitted to the NICU represent a vulnerable population.
- Understanding racial/ethnic differences in outcomes is crucial for equitable care.
- Previous studies have shown varied outcomes for preterm infants across different demographic groups.
Purpose of the Study:
- To determine if in-hospital mortality and morbidity differ among racial/ethnic groups in preterm neonates.
- To analyze outcomes including respiratory distress syndrome (RDS), interventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), and retinopathy of prematurity (ROP).
- To conduct a sub-analysis for very preterm (VPT) infants (<28 weeks).
Main Methods:
- Retrospective cohort study of preterm infants (<37 weeks) admitted to the NICU from 1994-2009.
- Exclusion of infants with structural anomalies or aneuploidy.
- Comparison of five racial/ethnic groups (REGs): White, Black, Hispanic, Asian, and Mixed, using logistic regression with White neonates as the referent group.
Main Results:
- No significant difference in in-hospital mortality (IHM) across REGs after controlling for covariates.
- Black and Hispanic neonates showed significantly different rates of RDS compared to White neonates.
- Hispanic neonates had a higher risk of ROP, while Mixed neonates had a reduced risk compared to White neonates.
- In VPT infants, Black neonates had significantly reduced IHM, and Mixed neonates had reduced ROP compared to White neonates.
Conclusions:
- In-hospital mortality does not significantly differ across racial/ethnic groups for preterm neonates.
- Black very preterm infants demonstrated improved in-hospital mortality.
- Significant differences in morbidity (RDS, ROP) exist among racial/ethnic groups, warranting further investigation.
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