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Rehospitalization of Extremely Low Birth Weight (ELBW) Infants: Are There Racial/Ethnic Disparities?

Abstract

BACKGROUND:

Premature infants are at increased risk for rehospitalization after discharge from the hospital. Racial disparities are known to exist in pediatric health care.

OBJECTIVE:

To evaluate whether racial disparities exist in the proportion of extremely low birth weight (ELBW) infants rehospitalized prior to 18 months corrected age and the causes of rehospitalization.

METHODS:

The National Institute of Child Health and Human Development Neonatal Research Network database was used to identify all ELBW infants (n=2446) who were born between November 1, 1998 and May 31, 2000 at the 14 participating centers and discharged alive (n=1591). Infants were seen at 18–22 months corrected age for followup. Data related to maternal variables, race, socioeconomic status, medical morbidities, insurance, and rehospitalizations were recorded from the medical record and parent interview. Logistic regression analyses were used to examine the relationship of race/ethnicity and rehospitalization while controlling for gestational age, gender, center, maternal education, family income, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis, ventriculoperitoneal (VP) shunt, respiratory syncytial virus (RSV) prophylaxis, and insurance type.

RESULTS:

In all, 1405 (88%) infants were evaluated at followup. The racial distribution of infants admitted, discharged, seen at followup, and rehospitalized were similar. Rehospitalization occurred at least once in 49% of the infants. In the logistic regression analyses, race was not a significant predictor for rehospitalization. The odds of rehospitalization were related to low family income, type of insurance, BPD, VP shunt, RSV prophylaxis, and center.

CONCLUSION:

Race was not a predominant variable in the risk of rehospitalization in this cohort of ELBW infants. Medical morbidities and low family income appear to be the major risk factors for rehospitalization.

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Acknowledgements

This work was funded by National Institute of Child Health and Human Development Grants U10 HD21397, U10 HD34216, U10 HD27853, U10 HD27871, U10 HD21364, U10 HD21415, U10 HD40689, U10 HD27856, U10 HD27904, U10 HD27881, U01 HD36790, U10 HD21385, U10 HD27880, U10 HD27851, U10 HD 21373, and General Clinical Research Center Grants M01 RR 08084, M01 RR 06022, M01 RR 00750, M01 RR 00997, M01 RR 00070. National Institute of Child Health and Human Development Neonatal Research Network Followup Principle Investigators 1998 to 2000:

Betty Vohr, MD — Chairman, Brown University

Dee Wilson-Costello, MD — Case Western Reserve University

Jean Steichen, MD — University of Cincinnati

Neal Simon, MD — Barbara Stoll, MD — Emory University

Anna Dusick, MD — Indiana University

Charles Bauer, MD — University of Miami

LuAnn Papile, MD — University of New Mexico

Susan Hintz, MD — Stanford University

Henrietta Bada, MD — University of Tennessee, Memphis

Sue Broyles, MD — University of Texas Southwestern at Dallas

Brenda Morris, MD — University of Texas at Houston

Virginia Delaney-Black, MD/ Yvette Johnson, MD — Wayne State University

Richard Ehrenkranz, MD — Yale University

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Morris, B., Gard, C., Kennedy, K. et al. Rehospitalization of Extremely Low Birth Weight (ELBW) Infants: Are There Racial/Ethnic Disparities?. J Perinatol 25, 656–663 (2005). https://doi.org/10.1038/sj.jp.7211361

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