Mortality Among Very Low-Birthweight Infants in Hospitals Serving Minority Populations

• Published in: American journal of public health (1971) 2005-12, Vol.95 (12), p.2206-2212
• Main Authors: Morales, Leo S, Staiger, Douglas, Horbar, Jeffrey D, Carpenter, Joseph, Kenny, Michael, Geppert, Jeffrey, Rogowski, Jeannette
• Format: Article
• Language: English
• Subjects: African Americans; Babies; Biological and medical sciences; Birth weight; Black people; Databases as Topic; Diseases of mother, fetus and pregnancy; European Continental Ancestry Group; Expenditures; Female; Gynecology. Andrology. Obstetrics; Hospitals; Humans; Inequality; Infant mortality; Infant Mortality - trends; Infant, Low Birth Weight; Infant, Newborn; Male; Medical sciences; Medicare; Minority & ethnic groups; Minority Groups; Miscellaneous; Multi-Institutional Systems; Multiple births; Patients; Pregnancy. Fetus. Placenta; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Racial differences; Regression Analysis; Research and Practice; Studies; Surgery; United States - epidemiology; White people
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2004.046730

We investigated whether the proportion of Black very low-birth-weight (VLBW) infants treated by hospitals is associated with neonatal mortality for Black and White VLBW infants. We analyzed medical records linked to secondary data sources for 74050 Black and White VLBW infants (501 g to 1500 g) treated by 332 hospitals participating in the Vermont Oxford Network from 1995 to 2000. Hospitals where more than 35% of VLBW infants treated were Black were defined as "minority-serving." Compared with hospitals where less than 15% of the VLBW infants were Black, minority-serving hospitals had significantly higher risk-adjusted neonatal mortality rates (White infants: odds ratio [OR]=1.30, 95% confidence interval [CI] = 1.09, 1.56; Black infants: OR = 1.29, 95% CI = 1.01, 1.64; Pooled: OR = 1.28, 95% CI=1.10, 1.50). Higher neonatal mortality in minority-serving hospitals was not explained by either hospital or treatment variables. Minority-serving hospitals may provide lower quality of care to VLBW infants compared with other hospitals. Because VLBW Black infants are disproportionately treated by minority-serving hospitals, higher neonatal mortality rates at these hospitals may contribute to racial disparities in infant mortality in the United States.