Differences in Very Preterm Infant Morbidity in New York
Mount Sinai Researchers Find Differences in Very
Preterm Infant Morbidity and Mortality Rates among New York
City Hospitals
Corresponding
Author: Elizabeth Howell, MD, Director of the
Women’s Health Institute, Icahn School of Medicine at
Mount Sinai, New York, and other coauthors.
To
watch a media release of Dr. Elizabeth Howell discussing her
important research click
here.
Bottom
Line: Poor performances at New York City hospitals
where non-Hispanic black and Hispanic mothers deliver are an
important and modifiable cause of racial disparities in
neonatal deaths and severe
complications.
Results: The
risk-standardized morbidity-mortality rate was twice
as high for preterm infants born in hospitals in the highest
morbidity-mortality tertile versus those born in
hospitals with the lowest
morbidity-mortality.
Why the Research Is
Interesting: Neonatal care has improved
substantially over the past decade, yet racial and ethnic
disparities in morbidity and mortality
continue.
Who: Thirty-nine New York City
hospitals were included in the study; participants included
7,177 “very preterm” infants born between 24 and 31
weeks.
When: The study examined data
from 2010-2014.
What: The study measured
the composite of mortality (neonatal or in-hospital up to a
year) or severe morbidity.
How: A
population-based retrospective study linked hospital
discharge abstract and birth-certificate data sets. A
risk-adjusted neonatal morbidity-mortality rate was
generated for very preterm infants in each hospital.
Hospitals were ranked using this measure, and differences in
the distribution of black, Hispanic, and white very preterm
births were assessed among the hospitals.
Study
Conclusions: Blacks and Hispanic very preterm
infants are more likely to be born at hospitals with higher
risk-adjusted neonatal morbidity-mortality rates, and these
differences contribute to excess morbidity and mortality
among black and Hispanic infants. These differences in
hospital of birth explained 39.9% of the black-white
disparity and 29.5% of the Hispanic-white disparity in
outcomes.
Paper Title: Differences in
Morbidity and Mortality Rates in Black, White, and Hispanic
Very Preterm Infants Among New York City
Hospitals
Said Mount Sinai's Dr. Elizabeth Howell
of the research:
It is very
important to seriously think about the cause for the severe
preterm babies’ morbidities and how it will affect these
children later on in life. When a baby is born prematurely,
many complications can occur—they can have problems with
their lungs, eyes, intestines, and brain, which will affect
them later on in life. The real focus here is to try to
reduce morbidity in preterm babies and give these kids a
chance at a healthier life. This study shines light on the
idea that we really need to focus on narrowing disparities
when we think about quality improvement. Additionally, these
disparities are not just local to New York City. We know
that there are infant and neonatal racial and ethnic
disparities that have been longstanding in this
country.