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Racial/Ethnic Disparities in Neonatal Intensive Care: A Systematic Review

Krista Sigurdson1,2,3, Briana Mitchell4,3, Jessica Liu4,3

  • 1Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, School of Medicine, Stanford University and Lucile Packard Children's Hospital, Palo Alto, California; ksigurd@stanford.edu.

Pediatrics
|July 31, 2019
PubMed

Insights

Racial and ethnic disparities exist in neonatal intensive care unit (NICU) care quality, often disadvantaging infants of color. This systematic review highlights these complex disparities across structure, process, and outcomes.

Area of Science:

  • Neonatal care
  • Health disparities
  • Quality improvement

Background:

  • Racial and ethnic disparities in newborn health outcomes are documented.
  • The specific contribution of neonatal intensive care unit (NICU) care to these disparities remains unclear.

Purpose of the Study:

  • To systematically review literature on racial/ethnic disparities in the quality of care provided to infants in the NICU setting.

Main Methods:

  • Searched Medline/PubMed, Scopus, CINAHL, and Web of Science until March 2018.
  • Included English language articles focusing on racial/ethnic differences in NICU care quality.
  • Two authors independently extracted data, with disagreements resolved by consensus.

Main Results:

  • Identified 41 articles for inclusion after reviewing 566 initial records.
  • Quantitative meta-analysis was not feasible due to study heterogeneity.
  • Observed complex racial/ethnic disparities in NICU structure, process, and outcome measures.

Conclusions:

  • The review revealed significant racial and/or ethnic disparities in NICU care, predominantly affecting infants of color, particularly African American infants.
  • These disparities manifest across various quality metrics.
  • Further analysis is needed for specific areas and potential mechanisms.
Abstract

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