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A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
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Racial and Ethnic Differences in Outcomes of Neonates Born at Less Than 30 Weeks' Gestation, 2018-2022.
Nansi S Boghossian1, Marco Geraci1,2, Erika M Edwards3,4,5
1Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia.
JAMA Network Open
|December 19, 2024
Summary
Black newborns experienced higher rates of necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) compared to White newborns. Addressing social determinants of health is crucial for improving health equity in neonatal outcomes.
Area of Science:
- Neonatalogy
- Health Equity Research
- Perinatal Epidemiology
Background:
- Previous studies explored preterm infant outcomes by parental race/ethnicity, but data during the COVID-19 pandemic remains limited.
- Understanding disparities in neonatal intensive care unit (NICU) outcomes is essential for addressing health inequities.
Purpose of the Study:
- To analyze trends in outcomes for Black, Hispanic, and Asian very preterm newborns compared to White newborns.
- To identify racial and ethnic disparities in neonatal outcomes during a recent period.
Main Methods:
- A cohort study analyzed data from 90,336 newborns born between 22 to 29 weeks gestation.
- Data was collected from 774 neonatal intensive care units within the Vermont Oxford Network between 2018 and 2022.
- Primary outcomes included mortality and complications such as necrotizing enterocolitis (NEC), late-onset sepsis (LOS), and severe intraventricular hemorrhage (sIVH).
Main Results:
- Black newborns had the highest rates of mortality, NEC, LOS, and severe intraventricular hemorrhage (sIVH) compared to White newborns.
- While mortality rate differences between Black and White newborns narrowed by 2022, Black newborns consistently showed higher rates of NEC and LOS.
- Hispanic newborns exhibited similar mortality and complication rates to White newborns, with Black and Hispanic newborns having lower respiratory complication rates and higher complication-free survival.
Conclusions:
- Despite no overall mortality difference by 2022, Black newborns faced higher rates of NEC and LOS, indicating persistent disparities.
- Addressing social determinants of health and implementing quality improvement initiatives are critical for achieving health equity in neonatal care.
- The findings underscore the need for targeted interventions to reduce disparities in preterm infant outcomes based on race and ethnicity.
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