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Black Race Is Associated with a Lower Risk of Bronchopulmonary Dysplasia

Rita M Ryan1, Rui Feng2, Catalina Bazacliu3

  • 1Department of Pediatrics, Medical University of South Carolina, Charleston, SC.

The Journal of Pediatrics
|January 8, 2019
PubMed

Insights

Black preterm infants (<29 weeks gestation) had a lower risk of bronchopulmonary dysplasia (BPD) but a higher risk of persistent respiratory disease compared to white infants. This finding highlights racial disparities in infant respiratory outcomes.

Area of Science:

  • Neonatology
  • Pediatric Pulmonology
  • Perinatal Research

Background:

  • Bronchopulmonary dysplasia (BPD) is a significant complication in preterm infants.
  • Racial disparities in BPD rates have been observed, but require further investigation in large contemporary cohorts.
  • Understanding these disparities is crucial for targeted interventions and improved infant respiratory health outcomes.

Purpose of the Study:

  • To compare the incidence of bronchopulmonary dysplasia (BPD) between Black and White infants born preterm (<29 weeks gestation).
  • To investigate potential racial differences in respiratory morbidity beyond the neonatal period in this vulnerable population.

Main Methods:

  • Prospective cohort study (Prematurity and Respiratory Outcome Program - PROP) of 835 infants born <29 weeks gestation (2011-2013).
  • Logistic regression analysis was used to compare BPD rates at 36 weeks postmenstrual age (PMA) between Black and White infants.
  • Analyses were adjusted for key confounding factors including gestational age, antenatal steroid use, and delivery room interventions.

Main Results:

  • Among 707 Black or White infants with available BPD outcomes, BPD occurred less frequently in Black infants (38%) compared to White infants (45%), despite lower gestational ages.
  • Black infants exhibited a significantly lower adjusted odds ratio (aOR) for BPD (0.60; 95% CI, 0.42-0.85).
  • Conversely, Black infants experienced a higher rate of first-year post-prematurity respiratory disease (79% vs. 63% in White infants).

Conclusions:

  • Black preterm infants (<29 weeks gestation) demonstrate a reduced risk of developing bronchopulmonary dysplasia compared to their White counterparts.
  • Despite lower BPD rates, Black infants face an increased burden of persistent respiratory morbidity in the first year post-prematurity.
  • These findings underscore the complex interplay of race, prematurity, and respiratory health, necessitating further research into underlying mechanisms and tailored care strategies.
Abstract

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