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Racial and Ethnic Disparities in Preterm Infant Mortality and Severe Morbidity: A Population-Based Study.
Neonatology. 2018; 113(1):44-54.N

Abstract

BACKGROUND

Disparities exist in the rates of preterm birth and infant mortality across different racial/ethnic groups. However, only a few studies have examined the impact of race/ethnicity on the outcomes of premature infants.

OBJECTIVE

To report the rates of mortality and severe neonatal morbidity among multiple gestational age (GA) groups stratified by race/ethnicity.

METHODS

A retrospective cohort study utilizing linked birth certificate, hospital discharge, readmission, and death records up to 1 year of life. Live-born infants ≤36 weeks born in the period 2007-2012 were included. Maternal self-identified race/ethnicity, as recorded on the birth certificate, was used. ICD-9 diagnostic and procedure codes captured neonatal morbidities (intraventricular hemorrhage, retinopathy of prematurity, periventricular leukomalacia, bronchopulmonary dysplasia, and necrotizing enterocolitis). Multiple logistic regression was performed to evaluate the impact of race/ethnicity on mortality and morbidity, adjusting for GA, birth weight, sex, and multiple gestation.

RESULTS

Our cohort totaled 245,242 preterm infants; 26% were white, 46% Hispanic, 8% black, and 12% Asian. At 22-25 weeks, black infants were less likely to die than white infants (odds ratio [OR] 0.76; 95% confidence interval [CI] 0.62-0.94). However, black infants born at 32-34 weeks (OR 1.64; 95% CI 1.15-2.32) or 35-36 weeks (OR 1.57; 95% CI 1.00-2.24) were more likely to die. Hispanic infants born at 35-36 weeks were less likely to die than white infants (OR 0.66; 95% CI 0.50-0.87). Racial disparities at different GAs were also detected for severe morbidities.

CONCLUSIONS

The impact of race/ethnicity on mortality and severe morbidity varied across GA categories in preterm infants. Disparities persisted even after adjusting for important potential confounders.

Authors+Show Affiliations

Department of Pediatrics, University of California San Diego, La Jolla, CA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29073624

Citation

Anderson, James G., et al. "Racial and Ethnic Disparities in Preterm Infant Mortality and Severe Morbidity: a Population-Based Study." Neonatology, vol. 113, no. 1, 2018, pp. 44-54.
Anderson JG, Rogers EE, Baer RJ, et al. Racial and Ethnic Disparities in Preterm Infant Mortality and Severe Morbidity: A Population-Based Study. Neonatology. 2018;113(1):44-54.
Anderson, J. G., Rogers, E. E., Baer, R. J., Oltman, S. P., Paynter, R., Partridge, J. C., Rand, L., Jelliffe-Pawlowski, L. L., & Steurer, M. A. (2018). Racial and Ethnic Disparities in Preterm Infant Mortality and Severe Morbidity: A Population-Based Study. Neonatology, 113(1), 44-54. https://doi.org/10.1159/000480536
Anderson JG, et al. Racial and Ethnic Disparities in Preterm Infant Mortality and Severe Morbidity: a Population-Based Study. Neonatology. 2018;113(1):44-54. PubMed PMID: 29073624.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Racial and Ethnic Disparities in Preterm Infant Mortality and Severe Morbidity: A Population-Based Study. AU - Anderson,James G, AU - Rogers,Elizabeth E, AU - Baer,Rebecca J, AU - Oltman,Scott P, AU - Paynter,Randi, AU - Partridge,J Colin, AU - Rand,Larry, AU - Jelliffe-Pawlowski,Laura L, AU - Steurer,Martina A, Y1 - 2017/10/27/ PY - 2017/05/10/received PY - 2017/08/22/accepted PY - 2017/10/27/pubmed PY - 2018/8/7/medline PY - 2017/10/27/entrez KW - Bronchopulmonary dysplasia KW - Intraventricular hemorrhage KW - Mortality KW - Necrotizing enterocolitis KW - Periventricular leukomalacia KW - Prematurity KW - Race KW - Retinopathy of prematurity SP - 44 EP - 54 JF - Neonatology JO - Neonatology VL - 113 IS - 1 N2 - BACKGROUND: Disparities exist in the rates of preterm birth and infant mortality across different racial/ethnic groups. However, only a few studies have examined the impact of race/ethnicity on the outcomes of premature infants. OBJECTIVE: To report the rates of mortality and severe neonatal morbidity among multiple gestational age (GA) groups stratified by race/ethnicity. METHODS: A retrospective cohort study utilizing linked birth certificate, hospital discharge, readmission, and death records up to 1 year of life. Live-born infants ≤36 weeks born in the period 2007-2012 were included. Maternal self-identified race/ethnicity, as recorded on the birth certificate, was used. ICD-9 diagnostic and procedure codes captured neonatal morbidities (intraventricular hemorrhage, retinopathy of prematurity, periventricular leukomalacia, bronchopulmonary dysplasia, and necrotizing enterocolitis). Multiple logistic regression was performed to evaluate the impact of race/ethnicity on mortality and morbidity, adjusting for GA, birth weight, sex, and multiple gestation. RESULTS: Our cohort totaled 245,242 preterm infants; 26% were white, 46% Hispanic, 8% black, and 12% Asian. At 22-25 weeks, black infants were less likely to die than white infants (odds ratio [OR] 0.76; 95% confidence interval [CI] 0.62-0.94). However, black infants born at 32-34 weeks (OR 1.64; 95% CI 1.15-2.32) or 35-36 weeks (OR 1.57; 95% CI 1.00-2.24) were more likely to die. Hispanic infants born at 35-36 weeks were less likely to die than white infants (OR 0.66; 95% CI 0.50-0.87). Racial disparities at different GAs were also detected for severe morbidities. CONCLUSIONS: The impact of race/ethnicity on mortality and severe morbidity varied across GA categories in preterm infants. Disparities persisted even after adjusting for important potential confounders. SN - 1661-7819 UR - https://www.unboundmedicine.com/medline/citation/29073624/Racial_and_Ethnic_Disparities_in_Preterm_Infant_Mortality_and_Severe_Morbidity:_A_Population_Based_Study_ L2 - https://www.karger.com?DOI=10.1159/000480536 DB - PRIME DP - Unbound Medicine ER -