Anderson JG, et al. - This study was implemented to analyze the rates of mortality and severe neonatal morbidity among racially/ ethnically stratified multiple gestational age (GA) groups. Findings demonstrated a variance in the effect of race/ethnicity on mortality and severe morbidity across GA categories in preterm infants. Notably, even after adjusting for important potential confounders, the disparities persisted.

Methods

• Researchers performed this retrospective cohort study utilizing linked birth certificate, hospital discharge, readmission, and death records up to 1 year of life.
• This study included live-born infants ≤36 weeks born in the period 2007-2012.
• Birth certificates were checked to determine maternal self-identified race/ethnicity.
• Researchers used ICD-9 diagnostic and procedure codes to capture neonatal morbidities (intraventricular hemorrhage, retinopathy of prematurity, periventricular leukomalacia, bronchopulmonary dysplasia, and necrotizing enterocolitis).
• In addition, they performed multiple logistic regression to assess the effect of race/ethnicity on mortality and morbidity, adjusting for GA, birth weight, sex, and multiple gestation.

Results

• A total of 245,242 preterm infants were assessed in this study; 26% were white, 46% Hispanic, 8% black, and 12% Asian.
• Death was less likely at 22-25 weeks among black infants vs white infants (odds ratio [OR] 0.76; 95% confidence interval [CI] 0.62-0.94).
• However, likelihood of death was more in 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).
• Findings demonstrated that Hispanic infants born at 35-36 weeks were less likely to die, compared with white infants (OR 0.66; 95% CI 0.50-0.87).
• Additionally, data revealed that racial disparities at different GAs were also detected for severe morbidities.