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Despite Improvement, Preterm Black Infants Still Face Gaps in Care and Health Outcomes

8/12/2019

U.S. Neonatal Intensive Care Units (NICUs) have reduced some of the race-based gaps in health outcomes and care provided for very preterm infants, according to new research in the September 2019 Pediatrics. However, findings showed that black infants born at least 10 weeks early remain less likely to receive certain treatments and more likely to die or experience some serious health outcomes than their white counterparts. For the National Institutes of Health-funded study, “Racial and Ethnic Differences Over Time in Outcomes of Infants Born Less Than 30 Weeks’ Gestation,” researchers analyzed 2006-2017 data for 224,297 infants drawn from the Vermont Oxford Network, a voluntary worldwide network including 789 NICUs in the U.S. focused on quality improvement. The infants were born between 22 to 29 weeks’ gestation. The researchers discovered a narrowing gap during the 12-year-study period in the rate for some evidence-based care practices, such as the use of antenatal corticosteroids to help a premature baby’s lungs function, as well as mortality (defined as death before discharge) and complications such as hypothermia and late-onset sepsis among black infants. However, by the end of the study period, black infants still had lower rates of vital care practices and higher rates of mortality, hypothermia, necrotizing enterocolitis, late-onset sepsis, and severe intraventricular hemorrhage than white infants. Study authors said the quality deficit among minority infants for several care practice measures, and potentially modifiable health outcomes suggests a critical role that quality improvement initiatives can play if tailored to hospitals serving minority populations. They encourage continued research to assess care and outcome trends for preterm infants to ensure that infants of all racial and ethnic backgrounds benefit equally from medical developments.

Editor’s note: The solicited commentary, “Improving Quality of Care Can Mitigate Persistent Disparities,” accompanies this study.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds