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. 2020 Mar;40(3):404-411.
doi: 10.1038/s41372-019-0423-9. Epub 2019 Jun 24.

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

Gia Yannekis  1 , Molly Passarella  2 , Scott Lorch  3
Affiliations

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

Gia Yannekis et al. J Perinatol. 2020 Mar.

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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Conflict of interest statement

Conflict of Interest

The authors declare no conflicts of interest.

Figures

Figure 1.1:
Figure 1.1:
Mortality Effect of High-Level, High-Volume Delivery Hospital on Minority versus Non-Hispanic White Neonates
Figure 1.2:
Figure 1.2:
Morbidity Effect of High-Level, High-Volume Delivery Hospital on Minority versus Non-Hispanic White Neonates
Figure 2:
Figure 2:
Morbidity Effect of High-Level, High-Volume Delivery Hospital for Individual Racial/Ethnic Groups versus Non-Hispanic White Neonates
Figure 3.1:
Figure 3.1:
Mortality Effect of High-Level, High-Volume Delivery Hospital on Publicly Insured/Uninsured versus Privately Insured Neonates
Figure 3.2:
Figure 3.2:
Morbidity Effect of High-Level, High-Volume Delivery Hospital on Publicly Insured/Uninsured versus Privately Insured Neonates
See this image and copyright information in PMC

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