A 2-fold higher rate of intraventricular hemorrhage–related mortality in African American neonates and infants

Qureshi, Adnan I.; Adil, Malik M; Shafizadeh, Negin; Majidi, Shahram

doi:10.3171/2013.4.peds12568

Cited by 16 publications

(11 citation statements)

References 23 publications

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“…14 A previous study found that Black infants were more than twice as likely to die from IVH compared with Whites, attributable in part to the excess risk of preterm birth among Blacks. 15 In an analysis limited to preterm deliveries similar to the current study, increased incidence of IVH among Blacks was attenuated among women with at least one prenatal visit, implicating racially-differential health care access and utilization. 16 An older study examined the causes and factors of developing PVH/IVH in premature infants and reported that mothers with pregnancy-induced hypertension were less likely to have neonates with PVH/IVH, likely attributable to medication use or obstetrical management.…”

Section: Commentsupporting

confidence: 51%

Racial/ethnic differences in preterm perinatal outcomes

Wallace

Mendola

Kim

et al. 2017

American Journal of Obstetrics and Gynecology

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Background Racial disparities in preterm birth and infant mortality have been well documented. Less is known about racial disparities in neonatal morbidities among infants born prior to 37 weeks. Objective The purpose of this study was to determine if risk for morbidity and mortality among infants born preterm differs by maternal race. Study Design A retrospective cohort design included medical records from preterm deliveries of 19,325 Black, Hispanic, and White women in the Consortium on Safe Labor. Sequentially-adjusted Poisson models with generalized estimating equations estimated racial differences in risk for neonatal morbidities and mortality controlling for maternal demographics, health behaviors, and medical history. Sex differences between and within race were examined. Results Black preterm infants had an elevated risk for perinatal death, but there was no difference in risk for neonatal death across racial groups. Relative to Whites, Black infants were significantly more likely to experience sepsis (9.1% vs. 13.6%), peri- or intraventricular hemorrhage (2.6% vs. 3.3%), intracranial hemorrhage (0.6% vs. 1.8%), and retinopathy of prematurity (1.0% vs. 2.6%). Hispanic and White preterm neonates had similar risk profiles. In general, female infants had lower risk relative to males, with White females having the lowest prevalence of a composite indicator perinatal death or any morbidity across all races (30.9%). Differences in maternal demographics, health behaviors, and medical history did little to influence these associations, which were robust to sensitivity analyses of pregnancy complications as potential underlying mechanisms. Conclusions Preterm infants were at similar risk for neonatal death regardless of race, but there were notable racial disparities and sex differences in rare, but serious adverse neonatal morbidities.

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Section: Commentsupporting

confidence: 51%

Racial/ethnic differences in preterm perinatal outcomes

Wallace

Mendola

Kim

et al. 2017

American Journal of Obstetrics and Gynecology

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“…One article 39 examined intraventricular hemorrhage (IVH)related mortality, finding that black infants had a twofold greater risk of IVH-related mortality compared with white infants, positing a pathophysiological predisposition in black infants to IVH.…”

Section: Intraventricular Hemorrhagementioning

confidence: 99%

Racial/Ethnic Disparities in Neonatal Intensive Care: A Systematic Review

et al. 2019

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CONTEXT: Racial and ethnic disparities in health outcomes of newborns requiring care in the NICU setting have been reported. The contribution of NICU care to disparities in outcomes is unclear. OBJECTIVE: To conduct a systematic review of the literature documenting racial/ethnic disparities in quality of care for infants in the NICU setting. DATA SOURCES: Medline/PubMed, Scopus, Cumulative Index of Nursing and Allied Health, and Web of Science were searched until March 6, 2018, by using search queries organized around the following key concepts: “neonatal intensive care units,” “racial or ethnic disparities,” and “quality of care.” STUDY SELECTION: English language articles up to March 6, 2018, that were focused on racial and/or ethnic differences in the quality of NICU care were selected. DATA EXTRACTION: Two authors independently assessed eligibility, extracted data, and cross-checked results, with disagreements resolved by consensus. Information extracted focused on racial and/or ethnic disparities in quality of care and potential mechanism(s) for disparities. RESULTS: Initial search yielded 566 records, 470 of which were unique citations. Title and abstract review resulted in 382 records. Appraisal of the full text of the remaining 88 records, along with the addition of 5 citations from expert consult or review of bibliographies, resulted in 41 articles being included. LIMITATIONS: Quantitative meta-analysis was not possible because of study heterogeneity. CONCLUSIONS: Overall, this systematic review revealed complex racial and/or ethnic disparities in structure, process, and outcome measures, most often disadvantaging infants of color, especially African American infants. There are some exceptions to this pattern and each area merits its own analysis and discussion.

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“…30–32 Further, infants of African ancestry mothers are less likely to receive surfactant or assisted ventilation, 33 and IVH-related mortality is two times higher in African ancestry neonates when compared to white preterm infants. 34 A recent large prospective analysis demonstrated that white race decreased risk for grades 2–4 IVH in preterm neonates of 500–1250 g; 29 notably, among white infants but not black neonates, multiple gestation was associated with increased risk of IVH, while higher maternal education was associated with a decreased incidence of hemorrhage. When compared to white neonates, infants of African ancestry less often received ANS exposure and required more vigorous delivery room resuscitation.…”

Section: Environmental Factors and Health Care Disparities Are Permismentioning

confidence: 99%

Genes and environment in neonatal intraventricular hemorrhage

Ment

Ådén

Bauer

et al. 2015

Seminars in Perinatology

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Emerging data suggest intraventricular hemorrhage (IVH) of the preterm neonate is a complex disorder with contributions from both the environment and the genome. Environmental analyses suggest factors mediating both cerebral blood flow and angiogenesis contribute to IVH, while candidate gene studies report variants in angiogenesis, inflammation and vascular pathways. Gene-by-environment interactions demonstrate the interaction between the environment and the genome, and a non-replicated genome-wide association study suggests that both environmental and genetic factors contribute to the risk for severe IVH in very low birth weight preterm neonates.

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A 2-fold higher rate of intraventricular hemorrhage–related mortality in African American neonates and infants

Cited by 16 publications

References 23 publications

Racial/ethnic differences in preterm perinatal outcomes

Racial/ethnic differences in preterm perinatal outcomes

Racial/Ethnic Disparities in Neonatal Intensive Care: A Systematic Review

Genes and environment in neonatal intraventricular hemorrhage

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