Differences in Neonatal Mortality Among Whites and Asian American Subgroups

Baker, Laurence C.; Afendulis, Christopher C.; Chandra, Amitabh; McConville, Shannon; Phibbs, Ciaran S.; Fuentes-Afflick, Elena

doi:10.1001/archpedi.161.1.69

Cited by 34 publications

(19 citation statements)

References 21 publications

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“…Although Chinese, Japanese, Korean, and Vietnamese mothers have lower rates of very low birth weight infants than white women, 16 controlling for birth weight did not close the gap in CP rates between Asians and whites in our study. Similarly, differences in frequency of birth asphyxia did not explain lower Asian CP rates.…”

Section: Figurecontrasting

confidence: 90%

“…It is well recognized that perinatal outcomes differ across different Asian subgroups. 8,9,13,14,16,18 For instance, neonatal mortality rates in the 1980s were lower in most Asian groups than in whites, except for Thai and Laotian infants, who exhibited increased neonatal mortality. 9 Among California births in the 1990s, Cambodian, Japanese, and Korean infants had lower neonatal mortality than white infants, whereas Thai infants experienced increased neonatal mortality.…”

Section: Discussionmentioning

confidence: 99%

“…9 Among California births in the 1990s, Cambodian, Japanese, and Korean infants had lower neonatal mortality than white infants, whereas Thai infants experienced increased neonatal mortality. 15,16 Birth weight outcomes also vary by ethnic subgroup, with Indians experiencing the highest risk of low birth weight among all Asian subgroups. 13,14,19 In this large, population-based study of California births, the risk of CP was…”

Section: Discussionmentioning

confidence: 99%

“…Thai infants exhibited the lowest CP rate in our study, even though Thai infants have the highest reported neonatal mortality among Asian subgroups. 9,16 It is possible that higher neonatal mortality rates with reduced survival to age 2, the age at which CP is typically diagnosed, could account for lower CP rates in specific subpopulations. However, neonatal mortality rates among many Asian groups in California have been lower than the rate seen in whites, 9,15,16 which would argue against differential survival as an explanation for the lower CP rates observed in Asians.…”

Section: Figurementioning

confidence: 99%

“…[12][13][14] For instance, Chinese and Japanese mothers have the highest educational attainment and the lowest infant mortality rates of all Asian subgroups, whereas Cambodian and Laotian mothers have lower educational attainment and higher infant mortality. 15,16 Whether the risk of CP varies among different Asian populations has not been studied. Therefore, in a large, multiethnic population in California, we compared the risk of CP in 13 different Asian subgroups and examined whether differences in sociodemographic factors explain the reduced risk of CP among Asians.…”

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confidence: 99%

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Cerebral Palsy Among Asian Ethnic Subgroups

2012

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT: Asian Americans have a reduced risk of cerebral palsy (CP) compared with whites. Whether this is true for all Asian ethnic subgroups is unknown. Differences in sociodemographic factors may explain disparities in CP prevalence between Asians and whites.WHAT THIS STUDY ADDS: East Asian, Filipino, Indian, Pacific Islander, and Southeast Asian children were 13% to 38% less likely to have CP than white children. Differences in maternal age and education, gender, and birth weight did not explain these differences in CP rates. abstract OBJECTIVE: Asians have a reduced risk for cerebral palsy (CP) compared with whites. We examined whether individual Asian subgroups have a reduced risk of CP and whether differences in sociodemographic factors explain disparities in CP prevalence. CONCLUSIONS: Most Asian national origin subgroups have a lower rate of CP than whites, and this disparity is unexplained. Additional studies that focus on the cause of ethnic disparities in CP may provide new insights into pathogenesis and prevention. Pediatrics 2012;129: e992-e998 AUTHORS:

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Section: Figurecontrasting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

mentioning

confidence: 99%

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Cerebral Palsy Among Asian Ethnic Subgroups

2012

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Racial Segregation and Inequality in the Neonatal Intensive Care Unit for Very Low-Birth-Weight and Very Preterm Infants

et al. 2019

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IMPORTANCE Racial and ethnic minorities receive lower-quality health care than white non-Hispanic individuals in the United States. Where minority infants receive care and the role that may play in the quality of care received is unclear. OBJECTIVE To determine the extent of segregation and inequality of care of very low-birth-weight and very preterm infants across neonatal intensive care units (NICUs) in the United States. DESIGN, SETTING, AND PARTICIPANTS This cohort study of 743 NICUs in the Vermont Oxford Network included 117 982 black, Hispanic, Asian, and white infants born at 401 g to 1500 g or 22 to 29 weeks’ gestation from January 2014 to December 2016. Analysis began January 2018. MAIN OUTCOMES AND MEASURES The NICU segregation index and NICU inequality index were calculated at the hospital level as the Gini coefficients associated with the Lorenz curves for black, Hispanic, and Asian infants compared with white infants, with NICUs ranked by proportion of white infants for the NICU segregation index and by composite Baby-MONITOR (Measure of Neonatal Intensive Care Outcomes Research) score for the NICU inequality index. RESULTS Infants (36 359 black [31%], 21 808 Hispanic [18%], 5920 Asian [5%], and 53 895 white [46%]) were segregated among the 743 NICUs by race and ethnicity (NICU segregation index: black: 0.50 [95% CI, 0.46–0.53], Hispanic: 0.58 [95% CI, 0.54–0.61], and Asian: 0.45 [95% CI, 0.40–0.50]). Compared with white infants, black infants were concentrated at NICUs with lower-quality scores, and Hispanic and Asian infants were concentrated at NICUs with higher-quality scores (NICU inequality index: black: 0.07 [95% CI, 0.02–0.13], Hispanic: −0.10 [95% CI, −0.17 to −0.04], and Asian: −0.26 [95% CI, −0.32 to −0.19]). There was marked variation among the census regions in weighted mean NICU quality scores (range: −0.69 to 0.85). Region of residence explained the observed inequality for Hispanic infants but not for black or Asian infants. CONCLUSIONS AND RELEVANCE Black, Hispanic, and Asian infants were segregated across NICUs, reflecting the racial segregation of minority populations in the United States. There were large differences between geographic regions in NICU quality. After accounting for these differences, compared with white infants, Asian infants received care at higher-quality NICUs and black infants, at lower-quality NICUs. Explaining these patterns will require understanding the effects of sociodemographic factors and public policies on hospital quality, access, and choice for minority women and their infants.

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Maternal Morbidity and Perinatal Outcomes Among Foreign-Born Cambodian, Laotian, and Vietnamese Americans in Washington State, 1993–2006

Cripe

O’Brien

Gelaye

et al. 2010

J Immigrant Minority Health

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This study examined differences in perinatal outcomes of Southeast Asian (SEA) women compared with non-Hispanic white women in Washington. Using linked birth certificate and hospitalization discharge records for the years 1993-2006, we compared singleton births of Cambodian (3,858), Laotian (2,223), and Vietnamese (12,949) women with a random sample of white women (35,581). Associations between maternal nativity and perinatal outcomes were assessed using multivariable logistic regression. There are clear nativity differences among SEAs for gestational diabetes mellitus, anemia, placenta previa and febrile illness. SEAs had increased risks for these disorders when compared with white women. Compared with infants delivered of white women, infants of SEAs had increased risks for moderate to heavy meconium, birth injury and low birth weight. Differences in nativity among SEAs (populations that are traditionally studied in aggregate) should be considered when designing and carrying out interventions to prevent adverse pregnancy morbidity and outcomes among immigrants.

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Differences in Neonatal Mortality Among Whites and Asian American Subgroups

Cited by 34 publications

References 21 publications

Cerebral Palsy Among Asian Ethnic Subgroups

Cerebral Palsy Among Asian Ethnic Subgroups

Racial Segregation and Inequality in the Neonatal Intensive Care Unit for Very Low-Birth-Weight and Very Preterm Infants

Maternal Morbidity and Perinatal Outcomes Among Foreign-Born Cambodian, Laotian, and Vietnamese Americans in Washington State, 1993–2006

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