Faculty Collaboration Database

Racial/ethnic differences in necrotizing enterocolitis incidence and outcomes in premature very low birth weight infants. J Perinatol 2018 Oct;38(10):1386-1390

Date

08/09/2018

Pubmed ID

30087454

DOI

10.1038/s41372-018-0184-x

Scopus ID

2-s2.0-85052317919 (requires institutional sign-in at Scopus site)   42 Citations

Abstract

BACKGROUND: As advances in neonatal intensive care increase the survival of extremely premature infants, the at-risk population for necrotizing enterocolitis (NEC) continues to rise. Although racial health disparities in preterm births have been well documented, large-scale studies exploring racial differences in NEC outcomes are lacking. Here, we conduct a study of racial health disparities in NEC using a nationally representative multicenter cohort.

STUDY DESIGN: Infants ≤1500 g birth weight and ≤30 weeks gestational age admitted in the first week after birth to neonatal intensive care units in the Pediatrix Medical group from 1997 to 2015 were included. Multivariable logistic regression was used to determine the adjusted odds ratio (AOR) of risk factors related to NEC and associated mortality.

RESULTS: Of the 126,089 (45% non-Hispanic White, 27% non-Hispanic Black, and 19% Hispanic) infants who met the inclusion criteria, 8796 (7%) developed NEC. On multivariable analysis, non-Hispanic Black and Hispanic infants had higher odds of developing NEC (AOR 1.31, 95% confidence interval (CI) [1.24-1.39], p < 0.001 and AOR 1.30 [1.21-1.39], p < 0.001, respectively). Among infants with NEC, mortality was higher in non-Hispanic Black and Hispanic infants compared to non-Hispanic White infants (AOR 1.35 [1.15-1.58], p < 0.001 and AOR 1.31 [1.09-1.56], p = 0.003, respectively).

CONCLUSION: Our study demonstrates that non-Hispanic Black and Hispanic infants are significantly more likely to be diagnosed with NEC. In addition, non-Hispanic Black and Hispanic infants have higher odds of death after NEC compared to non-Hispanic White infants. Further studies are necessary to investigate the etiology of these health disparities and to test interventions to improve these health outcomes.

Author List

Jammeh ML, Adibe OO, Tracy ET, Rice HE, Clark RH, Smith PB, Greenberg RG

Author

Momodou L. Jammeh MD Assistant Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Birth Weight
Cohort Studies
Enterocolitis, Necrotizing
Female
Gestational Age
Health Status Disparities
Humans
Incidence
Infant
Infant Mortality
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Logistic Models
Male
Multivariate Analysis
Risk Factors
United States