Rates of Neonatal Sepsis by Maternal Race, Education, and Insurance [22F

Abstract

INTRODUCTION: Given the dearth of current data comparing sepsis rates among infants based on maternal demographics, clinicians have little with which to evaluate a neonate's chances of developing sepsis. This study aims to characterize the rates of sepsis stratified by maternal race, education level, and insurance status. METHODS: This is a retrospective cohort study of 9,676,773 non-anomalous, singleton and twin deliveries in the United States. We conducted a chi-squared analysis comparing rates of sepsis among infants stratified by maternal race, education level, and insurance status. Multivariate analysis controlled for maternal age, diabetes, chronic hypertension, preeclampsia, chorioamnionitis, postpartum hemorrhage, cesarean section, nulliparity, and gestational age. RESULTS: Within our cohort, rates of neonatal sepsis were significantly higher among infants born to women with Medicaid insurance than those born to women without Medicaid insurance (2.00% vs. 1.27%; p<0.001). Infants with mothers who had no college education exhibited higher rates of neonatal sepsis than infants with mothers who had some college education (1.84% vs. 1.35%; p<0.001). Additionally, multivariate analysis showed that non-Hispanic Black race and Hispanic race were predictive for neonatal sepsis (OR 1.22, 95% CI 1.16-1.29; OR 1.17, 95% CI 1.13-1.21). CONCLUSION: In our cohort, Hispanic and non-Hispanic Black mothers exhibited an increased risk of giving birth to an infant who developed neonatal sepsis. Rates of sepsis were also significantly higher among infants born to mothers with Medicaid and to mothers with no college education. This research highlights a need for further investigation into the association between sepsis rates and demographic factors.