In some neonatal intensive care units (NICUs), minority newborns
received worse care than white children - but the opposite was true
at other facilities, Dr. Jochen Profit, of the Stanford University
School of Medicine in California and colleagues reported online
August 28 in Pediatrics.
According to the U.S. Centers for Disease Control and Prevention, in
2013 the infant mortality rate per 1,000 live births was about 5
among white and Hispanic mothers, and about 11 among black mothers.
NICU care is an understudied area, Profit told Reuters Health.
For the new study, the researchers analyzed data from 134 California
NICUs on 18,616 infants born from 2010 through 2014 weighing less
than 3.3 pounds.
To assess the infants' NICU care, the researchers used a scoring
system known as Baby-MONITOR, which takes into account things like
steroid use to promote healthy lungs, whether the baby acquired an
infection, whether the baby received a timely eye exam and whether
the baby was breastfeeding.
Other factors like the care mothers received before delivery, their
length of pregnancy and the general health of babies in the NICU
were taken into account, too.
When the researchers looked at all the data together, they found
that care did not differ greatly between white, Asian and black
infants. Hispanic infants and those in other minority groups did
have worse care than whites according to Baby-MONITOR scores,
Differences between races were larger for individual parts of the
Black infants were more likely to have chronic lung disease and a
collapsed lung, compared to white infants, for example.
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Black infants grew faster than white infants, however.
White infants scored as well or better on all measures than Hispanic
Differences in care were also tied to the NICUs' overall scores, the
NICUs that provided the worst care tended to have the smallest gap
in care between infants of different races, for example. In some
cases, black infants received better care than white infants.
"There is a lot of variation," said Profit.
"One of the main points of the analyses is that itís really
dangerous to use a broad brush," he said. "The results are really at
the level of the NICU."
He said the next step is to look at other data that provide more
information about societal issues that could influence care.
SOURCE: http://bit.ly/2wiMiOB and http://bit.ly/2wjcYyw Pediatrics,
online August 28, 2017.
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