Association of Primary Language with Very Low Birth Weight Outcomes in Hispanic Infants in California

Abstract

To determine the association of Spanish as a primary language for a family with the health outcomes of Hispanic infants with very low birthweight (VLBW, <1500g). Data from the California Perinatal Quality Care Collaborative linked to hospital discharge records were analyzed. Hispanic infants with VLBW born between 2009-2018 with a primary language of English or Spanish were included. Outcomes selected were hypothesized to be sensitive to language barriers. Multivariable logistic regression models and mixed models estimated associations between language and outcomes. Of 18,364 infants meeting inclusion criteria, 27% (n=4,976) were born to families with Spanish as a primary language. In unadjusted analyses, compared with infants of primarily English-speaking families, these infants had higher odds of hospital readmission within 1 year [OR 1.11 (95% CI 1.02-1.21)], higher odds to receive human milk at discharge [OR 1.32 (95% CI 1.23-1.42)], and lower odds of discharge home with oxygen [OR 0.83 (95% CI 0.73-0.94)]. In multivariable analyses, odds of readmission and home oxygen remained significant when adjusting for infant but not maternal and hospital characteristics. Higher odds for receipt of any human milk at discharge were significant in all models. Remaining outcomes did not differ between groups. Significant differences exist between Hispanic infants with VLBW of primarily Spanish- versus English-speaking families. Exploration of strategies to prevent readmissions of infants of families with Spanish as a primary language is warranted.