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Racial/ethnic differences in necrotizing enterocolitis incidence and outcomes in premature very low birth weight infants.
J Perinatol. 2018 10; 38(10):1386-1390.JP

Abstract

BACKGROUND

As advances in neonatal intensive care increase the survival of extremely premature infants, the at-risk population for necrotizing enterocolitis (NEC) continues to rise. Although racial health disparities in preterm births have been well documented, large-scale studies exploring racial differences in NEC outcomes are lacking. Here, we conduct a study of racial health disparities in NEC using a nationally representative multicenter cohort.

STUDY DESIGN

Infants ≤1500 g birth weight and ≤30 weeks gestational age admitted in the first week after birth to neonatal intensive care units in the Pediatrix Medical group from 1997 to 2015 were included. Multivariable logistic regression was used to determine the adjusted odds ratio (AOR) of risk factors related to NEC and associated mortality.

RESULTS

Of the 126,089 (45% non-Hispanic White, 27% non-Hispanic Black, and 19% Hispanic) infants who met the inclusion criteria, 8796 (7%) developed NEC. On multivariable analysis, non-Hispanic Black and Hispanic infants had higher odds of developing NEC (AOR 1.31, 95% confidence interval (CI) [1.24-1.39], p < 0.001 and AOR 1.30 [1.21-1.39], p < 0.001, respectively). Among infants with NEC, mortality was higher in non-Hispanic Black and Hispanic infants compared to non-Hispanic White infants (AOR 1.35 [1.15-1.58], p < 0.001 and AOR 1.31 [1.09-1.56], p = 0.003, respectively).

CONCLUSION

Our study demonstrates that non-Hispanic Black and Hispanic infants are significantly more likely to be diagnosed with NEC. In addition, non-Hispanic Black and Hispanic infants have higher odds of death after NEC compared to non-Hispanic White infants. Further studies are necessary to investigate the etiology of these health disparities and to test interventions to improve these health outcomes.

Authors+Show Affiliations

Duke University School of Medicine, Durham, NC, USA.Division of Pediatric Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA.Division of Pediatric Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA.Division of Pediatric Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA.Pediatrix-Obstetrix Center for Research and Education, Sunrise, FL, USA.Duke Clinical Research Institute, Durham, NC, USA. Department of Pediatrics, Duke University Medical Center, Durham, NC, USA.Duke Clinical Research Institute, Durham, NC, USA. rachel.greenberg@duke.edu. Department of Pediatrics, Duke University Medical Center, Durham, NC, USA. rachel.greenberg@duke.edu.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

30087454

Citation

Jammeh, Momodou L., et al. "Racial/ethnic Differences in Necrotizing Enterocolitis Incidence and Outcomes in Premature Very Low Birth Weight Infants." Journal of Perinatology : Official Journal of the California Perinatal Association, vol. 38, no. 10, 2018, pp. 1386-1390.
Jammeh ML, Adibe OO, Tracy ET, et al. Racial/ethnic differences in necrotizing enterocolitis incidence and outcomes in premature very low birth weight infants. J Perinatol. 2018;38(10):1386-1390.
Jammeh, M. L., Adibe, O. O., Tracy, E. T., Rice, H. E., Clark, R. H., Smith, P. B., & Greenberg, R. G. (2018). Racial/ethnic differences in necrotizing enterocolitis incidence and outcomes in premature very low birth weight infants. Journal of Perinatology : Official Journal of the California Perinatal Association, 38(10), 1386-1390. https://doi.org/10.1038/s41372-018-0184-x
Jammeh ML, et al. Racial/ethnic Differences in Necrotizing Enterocolitis Incidence and Outcomes in Premature Very Low Birth Weight Infants. J Perinatol. 2018;38(10):1386-1390. PubMed PMID: 30087454.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Racial/ethnic differences in necrotizing enterocolitis incidence and outcomes in premature very low birth weight infants. AU - Jammeh,Momodou L, AU - Adibe,Obinna O, AU - Tracy,Elisabeth T, AU - Rice,Henry E, AU - Clark,Reese H, AU - Smith,P Brian, AU - Greenberg,Rachel G, Y1 - 2018/08/07/ PY - 2018/01/31/received PY - 2018/07/09/accepted PY - 2018/06/18/revised PY - 2018/8/9/pubmed PY - 2019/11/15/medline PY - 2018/8/9/entrez SP - 1386 EP - 1390 JF - Journal of perinatology : official journal of the California Perinatal Association JO - J Perinatol VL - 38 IS - 10 N2 - BACKGROUND: As advances in neonatal intensive care increase the survival of extremely premature infants, the at-risk population for necrotizing enterocolitis (NEC) continues to rise. Although racial health disparities in preterm births have been well documented, large-scale studies exploring racial differences in NEC outcomes are lacking. Here, we conduct a study of racial health disparities in NEC using a nationally representative multicenter cohort. STUDY DESIGN: Infants ≤1500 g birth weight and ≤30 weeks gestational age admitted in the first week after birth to neonatal intensive care units in the Pediatrix Medical group from 1997 to 2015 were included. Multivariable logistic regression was used to determine the adjusted odds ratio (AOR) of risk factors related to NEC and associated mortality. RESULTS: Of the 126,089 (45% non-Hispanic White, 27% non-Hispanic Black, and 19% Hispanic) infants who met the inclusion criteria, 8796 (7%) developed NEC. On multivariable analysis, non-Hispanic Black and Hispanic infants had higher odds of developing NEC (AOR 1.31, 95% confidence interval (CI) [1.24-1.39], p < 0.001 and AOR 1.30 [1.21-1.39], p < 0.001, respectively). Among infants with NEC, mortality was higher in non-Hispanic Black and Hispanic infants compared to non-Hispanic White infants (AOR 1.35 [1.15-1.58], p < 0.001 and AOR 1.31 [1.09-1.56], p = 0.003, respectively). CONCLUSION: Our study demonstrates that non-Hispanic Black and Hispanic infants are significantly more likely to be diagnosed with NEC. In addition, non-Hispanic Black and Hispanic infants have higher odds of death after NEC compared to non-Hispanic White infants. Further studies are necessary to investigate the etiology of these health disparities and to test interventions to improve these health outcomes. SN - 1476-5543 UR - https://www.unboundmedicine.com/medline/citation/30087454/Racial/ethnic_differences_in_necrotizing_enterocolitis_incidence_and_outcomes_in_premature_very_low_birth_weight_infants_ L2 - https://doi.org/10.1038/s41372-018-0184-x DB - PRIME DP - Unbound Medicine ER -