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A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
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Structural racism is associated with adverse postnatal outcomes among Black preterm infants

Kayla L Karvonen1,2, Safyer McKenzie-Sampson3,4, Rebecca J Baer3,5

  • 1Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA. kayla.karvonen@ucsf.edu.

Pediatric Research
|December 28, 2022
PubMed

Insights

Structural racism, measured by segregation, is linked to worse health outcomes for Black preterm infants after hospital discharge. This includes more frequent acute care visits, readmissions, and deaths in the first year of life.

Area of Science:

  • Public Health
  • Sociology
  • Neonatal Medicine

Background:

  • Structural racism is a known contributor to racial disparities in perinatal health outcomes.
  • Racial and income segregation are key indicators of structural racism.
  • Adverse outcomes for Black preterm infants postnatally are a significant public health concern.

Purpose of the Study:

  • To investigate the association between structural racism and adverse postnatal outcomes in Black preterm infants.
  • To quantify the impact of racial and income segregation on the health of Black preterm infants after hospital discharge.

Main Methods:

  • An observational cohort study of 13,321 Black birthing people delivering preterm infants in California (2011-2017).
  • Utilized statewide birth cohort data and American Community Survey data.
  • Quantified racial and income segregation using Index of Concentration at the Extremes (ICE) scores.
  • Employed multivariable generalized estimating equations to assess associations between ICE scores and adverse postnatal outcomes (acute care visits, readmissions, death).

Main Results:

  • Black birthing people in the least privileged ICE tertiles had infants with higher rates of frequent acute care visits (cRR 1.3), readmissions (cRR 1.1), and post-discharge death (cRR 1.9) in the first year.
  • These associations remained significant after adjusting for infant and birthing person characteristics.
  • Findings highlight the detrimental impact of segregation on infant health outcomes.

Conclusions:

  • Structural racism, as indicated by racial and income segregation, is associated with adverse postnatal outcomes for Black preterm infants.
  • These disparities persist beyond the perinatal period, impacting infant health after hospital discharge.
  • Addressing structural racism is crucial for reducing racial disparities in postnatal outcomes for preterm infants.
Abstract

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