Neonatal mortality and disparities within the military health system

Vereen, Rasheda J.; Nestander, Matthew; Haischer-Rollo, Gayle; Aden, James K; Drumm, Caitlin M

doi:10.1038/s41372-022-01598-w

Cited by 2 publications

(2 citation statements)

References 30 publications

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“…However, a recent publication on neonatal mortality in the MHS showed persistent racial disparities, with a 2-fold higher neonatal mortality rate for non-Hispanic Black neonates compared with White neonates despite an overall lower neonatal mortality rate in the MHS. 18 This difference was likely related to an overall higher rate of preterm birth in non-Hispanic Black neonates in this cohort. 18 Another limitation is that the NPIC database only includes individuals who actually received care in the MHS, and does not include patients who had coverage but might have been unable to obtain care in the system.…”

Section: Discussionmentioning

confidence: 82%

“… 18 This difference was likely related to an overall higher rate of preterm birth in non-Hispanic Black neonates in this cohort. 18 Another limitation is that the NPIC database only includes individuals who actually received care in the MHS, and does not include patients who had coverage but might have been unable to obtain care in the system. Another limitation was that approximately one-third of the self-identified race data were classified as unknown (5%) or other (28%), and this proportion varied among facilities.…”

Section: Discussionmentioning

confidence: 82%

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Obstetrical health care inequities in a universally insured health care system

Fuller

Kuenstler

Snipes

et al. 2023

AJOG Global Reports

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 82%

Obstetrical health care inequities in a universally insured health care system

Fuller

Kuenstler

Snipes

et al. 2023

AJOG Global Reports

View full text Add to dashboard Cite

Neonatal Survival and Outcomes following Periviable Rupture of Membranes

Okonek,

Schulz,

Belzer

et al. 2024

Am J Perinatol

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Objective To clarify survival for infants affected by periviable prolonged preterm premature rupture of membranes (PPROM) in the military health system (MHS). To add to current literature on outcomes following expectant management, including long-term neurodevelopment outcomes. Study Design Retrospective matched cohort review of six level 3 military neonatal intensive care units (NICUs; 2010–2020). Cases were matched 1:1 with control infants, matched by location, gender, gestational age (within 1 week), birth weight (within 300 g), and rupture of membranes (ROM) within 24 hours of delivery. Follow-up data were obtained for each infant through 48 months' corrected age or age of last documented health visit in a military treatment facility. Results Forty-nine infants met inclusion criteria. Mean ROM for cohort infants was 20.7 weeks, with mean latency period of 34.6 days and mean gestational age at delivery of 25.7 weeks. Cohort infants had a mean birth weight of 919 g. Cohort survival to NICU discharge was 75.5 versus 77.6% of controls (p = 0.81). Statistically significant short-term outcomes: oligohydramnios or anhydramnios at delivery (p < 0.0001), pulmonary hypertension (p = 0.0003), and high-frequency ventilation (p = 0.004) were higher in cohort infants. No differences were found regarding rates of early sepsis, intraventricular hemorrhage, surgical necrotizing enterocolitis, oxygen at 36 weeks or at discharge. No statistical difference in long-term outcomes at 18 to 48 months of age or incidence of autism, cerebral palsy, attention deficit hyperactivity disorder, or asthma. Conclusion Cohort survival to discharge in the MHS was 75.5%, higher than previously reported and not different from matched controls. Infants born after periviable PPROM should deliver at centers with access to high-frequency ventilation and ability to manage pulmonary hypertension. There was no difference in long-term neurodevelopment between the groups. Key Points

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Neonatal mortality and disparities within the military health system

Cited by 2 publications

References 30 publications

Obstetrical health care inequities in a universally insured health care system

Obstetrical health care inequities in a universally insured health care system

Neonatal Survival and Outcomes following Periviable Rupture of Membranes

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