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

Journal of Perinatology volume 40, pages 404–411 (2020)Cite this article

Subjects

Abstract

Objective

To describe variation in mortality and morbidity effects of high-level, high-volume delivery hospital between racial/ethnic groups and insurance groups.

Study Design

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.

Result

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.

Conclusions

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.

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Funding

This work was supported by a grant R01 HD084819.

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Authors and Affiliations

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

    Gia Yannekis

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

    Molly Passarella & Scott Lorch

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Contributions

SL obtained data for the project. GY and SL both contributed to idea development, project design, data analysis, and manuscript writing and editing. MP prepared data and assisted with data analysis.

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Correspondence to Scott Lorch.

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Yannekis, G., Passarella, M. & Lorch, S. Differential effects of delivery hospital on mortality and morbidity in minority premature and low birth weight neonates. J Perinatol 40, 404–411 (2020). https://doi.org/10.1038/s41372-019-0423-9

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