Trends in neonatal intensive care unit admissions by race/ethnicity in the United States, 2008\u20132018

Youngran Kim,Wenyaw Chan,Cecilia Ganduglia-Cazaban,Minjae Lee,David C Goodman

doi:10.1038/s41598-021-03183-1

Abstract

To examine temporal trends of NICU admissions in the U.S. by race/ethnicity, we conducted a retrospective cohort analysis using natality files provided by the National Center for Health Statistics at the U.S. Centers for Disease Control and Prevention. A total of 38,011,843 births in 2008–2018 were included. Crude and risk-adjusted NICU admission rates, overall and stratified by birth weight group, were compared between white, black, and Hispanic infants. Crude NICU admission rates increased from 6.62% (95% CI 6.59–6.65) to 9.07% (95% CI 9.04–9.10) between 2008 and 2018. The largest percentage increase was observed among Hispanic infants (51.4%) compared to white (29.1%) and black (32.4%) infants. Overall risk-adjusted rates differed little by race/ethnicity, but birth weight-stratified analysis revealed that racial/ethnic differences diminished in the very low birth weight (< 1500 g) and moderately low birth weight (1500–2499 g) groups. Overall NICU admission rates increased by 37% from 2008 to 2018, and the increasing trends were observed among all racial and ethnic groups. Diminished racial/ethnic differences in NICU admission rates in very low birth weight infants may reflect improved access to timely appropriate NICU care among high-risk infants through increasing health care coverage coupled with growing NICU supply.

Highlights

To examine temporal trends of neonatal intensive care units (NICUs) admissions in the U.S by race/ethnicity, we conducted a retrospective cohort analysis using natality files provided by the National Center for Health Statistics at the U.S Centers for Disease Control and Prevention
We examined temporal trends of NICU admissions by race/ethnicity in the U.S for all birth weight ranges at the national level and conducted subgroup analyses birth weight group
When we limited our analysis to births in the U.S states where the 2003 revision had been used throughout the entire study period, we found that trends in NICU admission overall and by race/ethnicity were consistent (Supplemental Table 6)

Summary

Introduction

To examine temporal trends of NICU admissions in the U.S by race/ethnicity, we conducted a retrospective cohort analysis using natality files provided by the National Center for Health Statistics at the U.S Centers for Disease Control and Prevention. Diminished racial/ethnic differences in NICU admission rates in very low birth weight infants may reflect improved access to timely appropriate NICU care among high-risk infants through increasing health care coverage coupled with growing NICU supply. Some very premature newborns were still not admitted to Level III/IV NICUs. there is evidence that greater bed supply is associated with high NICU admissions, among low-risk n ewborns[7,8,9,10]. There is evidence that greater bed supply is associated with high NICU admissions, among low-risk n ewborns[7,8,9,10] These raise important concerns regarding access to NICU care. We examined temporal trends of NICU admissions by race/ethnicity in the U.S for all birth weight ranges at the national level and conducted subgroup analyses birth weight group

Methods

Results

Discussion

Conclusion