Differential effects of delivery hospital on mortality and morbidity in minority premature and low birth weight neonates.


Journal

Journal of perinatology : official journal of the California Perinatal Association
ISSN: 1476-5543
Titre abrégé: J Perinatol
Pays: United States
ID NLM: 8501884

Informations de publication

Date de publication:
03 2020
Historique:
received: 05 12 2018
accepted: 22 05 2019
revised: 08 05 2019
pubmed: 27 6 2019
medline: 29 9 2020
entrez: 26 6 2019
Statut: ppublish

Résumé

To describe variation in mortality and morbidity effects of high-level, high-volume delivery hospital between racial/ethnic groups and insurance groups. Retrospective cohort including infants born at 24-32 weeks gestation or birth weights ≤2500 g in California, Missouri, and Pennsylvania between 1995 and 2009 (n = 636,764). Multivariable logistic random-effects models determined differential effects of birth hospital level/volume on mortality and morbidity through an interaction term between delivery hospital level/volume and either maternal race or insurance status. Compared to non-Hispanic white neonates, odds of complications of prematurity were 14-25% lower for minority infants in all gestational age and birth weight cohorts delivering at high-level, high-volume centers (odds ratio (ORs) 0.75-0.86, p < 0.001-0.005). Effect size was greatest for Hispanic infants. No difference was noted by insurance status. Neonates of minority racial/ethnic status derive greater morbidity benefits than non-Hispanic white neonates from delivery at hospitals with high-level, high-volume neonatal intensive care units.

Identifiants

pubmed: 31235781
doi: 10.1038/s41372-019-0423-9
pii: 10.1038/s41372-019-0423-9
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

404-411

Subventions

Organisme : NICHD NIH HHS
ID : R01 HD084819
Pays : United States

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Auteurs

Gia Yannekis (G)

Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Molly Passarella (M)

Division of Neonatology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Scott Lorch (S)

Division of Neonatology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. lorch@email.chop.edu.

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