Neonatal Intensive Care Unit Cultural Familiarity Shows Limited Impact on Outcomes among Asian American, Native...

This study aims to assess whether cultural familiarity, measured by Asian American, Native Hawaiian, and Pacific Islander (AANHPI) hospital patient volume, is associated with care processes and outcomes among very low birth weight (VLBW) infants.

We analyzed 43,067 infants, including 6,534 (15.2%) AANHPI infants, from 142 California neonatal intensive care units (NICUs) in the California Perinatal Quality Care Collaborative (2011-2019). Hospitals were grouped into tertiles by AANHPI VLBW admissions. Multivariable Poisson regression was adjusted for infant, maternal, and hospital factors.

Mortality and major morbidities did not differ by AANHPI patient volume. Unadjusted analyses showed higher human milk use at discharge in high- and middle-tertile NICUs (79.2% and 77.0 vs. 69.6%, p < 0.001), and higher growth velocity in high-tertile NICUs compared to low-tertile NICUs (13.3 vs. 12.8 g/kg/day, p < 0.001), but these differences were attenuated after adjustment.

NICU AANHPI VLBW patient volume was associated with feeding-related outcomes but not neonatal morbidity and mortality.

· Higher AANHPI NICU volume was linked to greater human milk use at discharge.. · High-volume NICUs showed higher growth velocity among VLBW infants.. · Mortality and major morbidities did not differ by AANHPI patient volume.. · Feeding advantages in high-volume NICUs attenuated after adjustment.. · Cultural familiarity may influence feeding practices more than survival..