women are 49% more likely to give birth early, which is linked to increased
mortality, making preterm birth or low birth weight the leading cause of infant
death among black infants. A review article in the August 2019 Pediatrics,
“Racial/Ethnic Disparities in Neonatal Intensive Care: A Systematic Review,” found that unequal quality of neonatal care may
be a contributing factor. The study, which publishes online July
29, found racial or ethnic disparities in care received at neonatal
intensive care units (NICU) that often-disadvantaged black infants, and often
resulted in worse outcomes for the babies. Researchers reviewed more than
560 studies, focusing on 41 studies of interest, and found research showing
disparities in care for non-white patients in the NICU, for example:
African American women were less likely to deliver in
top-tier hospitals and “minority-serving” hospitals had significantly
higher neonatal mortality rates.
ratio was significantly higher in “minority-serving” hospitals, and moms
and babies there received 50% less care.
birth weight infants of African American mothers were less likely to
receive referrals for early intervention and high-risk infant follow up.
African American mothers reported receiving limited
breastfeeding education and support during pregnancy, childbirth, NICU
stays, postpartum, and recovery in the community.
concluded that targeted quality improvement efforts hold promise for improving
racial/ethnic equity in care delivery.
Editor’s Note: A solicited commentary,
“Disparities in Neonatal Intensive Care: Context Matters,” will be published in the same issue of Pediatrics.
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