Premature black babies are more likely than white infants to end up in lower-quality neonatal intensive care units (NICUs), a new study reveals.
Researchers from the University of Vermont found the lowest-ranking NICUs held more than 30 percent of all black preemies.
Only 20 percent of the babies in the highest-ranking units were African American.
The team says that the quality of care at these hospitals is directly related to the deaths of newborns and even for complications such as asthma and developmental delays that, in some cases, can last for the rest of their lives.
A new study from the University of Vermont found that the lowest-ranking NICUs in the US held more than 30 percent of all black preemies (file image)
Almost one out of every 10 infants born in the US is premature, according to the Centers for Disease Control and Prevention.
Premature birth occurs when a baby arrives at least three weeks early, or at 37 weeks’ gestation.
Babies born prematurely suffer a greater risk of breathing problems, feeding problems and are more susceptible to contracting infections.
It is the largest cause of infant mortality in the US. In 2015, preterm birth and low-birth weights accounted for approximately 17 percent of infant deaths.
Additionally, a report last year found that black women have the highest risk of giving birth to a preemie at a rate of 13.4 percent, while the lowest rate is among white women at 8.9 percent.
For the new study, published in JAMA Pediatrics, the team analyzed data from the Vermont Oxford Network, which gathers information from NICUs around the world.
Researchers studied nearly 118,000 black, Asian, Hispanic and white babies born between January 2014 and December 2016.
The infants were born from 22 to 29 weeks of pregnancy and weighed anywhere from 14 ounces to around three pounds.
Quality of the NICUs was based on nine factors, including infant mortality during birth hospitalization, health-care associated bacterial or fungal infection, a timely eye exam and chronic lung disease.
The researchers found that minorities tended to end up at different hospitals than whites and that black babies were more likely to be treated at a lower-quality NICUs.
In fact, black preemies represented more than one-third of all babies in the lowest-ranked NICUs, but just one-fifth of the infants in the highest-ranking units.
The team also found that both Asian and Hispanic premature infants were more likely to be in higher-quality NICUs than white babies.
Co-author Dr Erika Edwards, a research assistant in the department of mathematics and engineering at the University of Vermont, said US Census data may explain some of the findings.
For example, higher-quality NICUs were often found in the Pacific region, where a large proportion of Hispanic families live.
‘[It did not explain] for Asian infants and did not explain the lower quality scores for black infants,’ she told DailyMail.com.
She said the team is not sure why black infants are more likely to end up at a lower-quality NICU, but they have several theories.
‘Many unmeasured factors, including structural racism, neighborhood of residence, maternal insurance coverage, immigration status, hospital location and financing, and public policies, among others, could explain our findings,’ Dr Edwards said.
For future research, she says she wants to look at how socioeconomic and demographic factors may play a role.
‘Black people don’t always end up at the closest hospital to them and we don’t necessarily know why,’ she said.
‘Certainly there are a number of theories. It could be related to insurance and which hospitals accept which insurance. Where deliveries occur could depend on whether a physician [is authorized] to deliver at a particular hospital.’
In an accompanying editorial, Dr Elizabeth Howell, a professor of obstetrics, gynecology and reproductive science at the Icahn School of Medicine at Mount Sinai in New York City, says this is the first study to look at the racial segregation of infants on a national level.
‘We’ve been looking at these kinds of questions in medicine across the board, not just in neonatal care,’ Dr Howell said.
‘Residential segregation, I think, is one of the biggest factors. However, there are other factors. We need to understand the underlying causes if we are going to target interventions to reduce disparities and improve care.’