Ethnic differences in risk factors for neonatal mortality and morbidity in the neonatal intensive care unit

Abstract

Objective: Although our knowledge about how to care for high-risk neonates who require intensive care is continually improving, disparities in health outcomes among various ethnic groups living in developed countries are becoming more evident. The purpose of this study was to identify the risk factors for neonatal intensive care unit (NICU) mortality among Canadian-born minority infants and, furthermore, to determine whether ethnicity was in itself an independent predictor of mortality or major morbidity in the NICU.Study design: Data were prospectively gathered on 6528 infants admitted to nine regionally located NICUs across Canada. Multiple logistic regressions were used to develop risk-adjusted models for NICU mortality and major morbidity.Result: Despite adjusting for differences in small for gestational age (SGA), outborn status and gestational age less than or equal to 28 weeks, South Asian infants still had significantly greater odds of mortality in the NICU. Neonatal sepsis was the strongest predictor of mortality among African infants, even greater than birth at 28 weeks or less. At significantly greater odds of survival with major morbidity were Aboriginal males and East Asian females. Conclusion:There are ethnic disparities in the risks of neonatal mortality and morbidity in the NICU. Understanding these differences is important to be able to determine specific areas to target in improving healthcare delivery and reducing disparities in health outcomes among Canada's diverse population.

Deprivation, ethnicity and prematurity in infant respiratory failure in PICU in the UK

“…South Asian children in the UK may have a lower incidence of wheezing illnesses (17). The data here show a lower rate of admission with bronchiolitis and specifically RSV bronchiolitis, which are consistent with these findings Evidence from neonatal intensive care suggests that children of South Asian origin may have higher mortality (18). The data for acute respiratory failure appear to suggest a similar poorer outcome.…”

Cellular and Kaposi’s sarcoma-associated herpes virus microRNAs in sepsis and surgical trauma

“…Racial disparities in the sepsis incidence and outcome have been noted in subgroups such as posttransplant patients, 26 cancer patients, 27 postoperative patients 28 and neonates. 29 Although the racial disparities may be attributed to ‘biological differences' between races, the KSHV prevalence in the Afro-American population is at least a plausible contributing factor to high sepsis mortality.…”

Epidemiology of critically ill children in England and Wales: incidence, mortality, deprivation and ethnicity

“…Excess mortality in infants of south Asian origin has also been observed in the neonatal intensive care population in Canada, even after adjusting for those small for gestational age and short gestation 32. Although there is some evidence that class inequalities in self-rated health seen in the white population are not apparent in Pakistani and Bangladeshi adults,33 it is not clear why there is such a strong interaction between less deprived children of south Asian origin and excess mortality.…”