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Maternal language disparities in neonatal intensive care unit outcomes

Journal of Perinatology volume 42, pages 723–729 (2022)Cite this article

Subjects

Abstract

Objective

To examine associations of maternal primary language with neonatal intensive care unit (NICU) outcomes (mother’s milk at discharge, necrotizing enterocolitis [NEC], late-onset sepsis, weight gain)

Design

We performed a retrospective cohort study of mother-infant dyads (<34 weeks’ gestation) in 9 NICUs (1/2016-12/2019), examining associations of maternal language (English [ref], Spanish, Other) with NICU outcomes, adjusting for birth weight for gestational age z-score, race/ethnicity, maternal age, and clustering by hospital.

Results

Among 1402 mothers, 85% spoke English, 7% spoke Spanish, and 7% spoke another language. Compared to English, infants with Spanish-speaking mothers had slower growth (−0.34 z-score units [−0.58, −0.10]). Infants with other non-English-speaking mothers had increased mother’s milk at discharge (aOR 1.48 [1.18, 1.85]), NEC (aOR 1.43 [1.05, 1.95]), late-onset sepsis (aOR 2.84) [1.67, 4.83] and slower growth (−0.17 z-score units [−0.29, −0.05]).

Conclusions

After adjustments, preterm infants with non-English-speaking mothers had worse outcomes than infants with English-speaking mothers.

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Acknowledgements

We would like to acknowledge the hospitals that participated in this NeoQIC data collection: Baystate Medical Center, Beth Israel Deaconess Medical Center, Boston Medical Center, Brigham and Women’s Hospital, Massachusetts General Hospital, St. Elizabeth’s Medical Center, Tufts Medical Center, South Shore Hospital, and UMass Memorial Hospital.

Funding

MGP and MG and PM received grant support from the W.K. Kellogg Foundation (P3031871).

Author information

Authors and Affiliations

  1. Department of Newborn Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Nikita S. Kalluri

  2. Program for Patient Safety and Quality, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Patrice Melvin

  3. Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Mandy B. Belfort

  4. Department of Neonatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Munish Gupta

  5. Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA

    Erika G. Cordova-Ramos & Margaret G. Parker

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Contributions

NSK conceptualized and designed the study as well as drafted the initial manuscript and revised the final manuscript. PM assisted in the design of the study and carried out the final data analyses. MBB, MG, EGCR and PM critically reviewed the manuscript for intellectual content and analysis review. MGP assisted in the conceptualization and design of the study, supervised the data analysis and the manuscript draft process, and critically reviewed the final version of the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Nikita S. Kalluri.

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The authors declare no competing interests.

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Kalluri, N.S., Melvin, P., Belfort, M.B. et al. Maternal language disparities in neonatal intensive care unit outcomes. J Perinatol 42, 723–729 (2022). https://doi.org/10.1038/s41372-021-01250-z

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