471 - Disparities in Neonatal Mortality: Origins of the Disease

Poster Number: 471
Publication Number: 471.129

Maria Burdjalov, The Ohio State University, Pepper Pike, OH, United States; Ibrahim Qattea, Case Western Reserve University School of Medicine, Lakewood, OH, United States; Mohamed A. Mohamed, Cleveland Clinic Children's, Cleveland, OH, United States; Hany Aly, Cleveland Clinic Children's Hospital, Cleveland, OH, United States

Background: There are high racial/ethnic disparities for infant mortality in the United States and infants of non-Hispanic Black women consistently have higher mortality rates than infants of non-Hispanic White women. The top three causes for infant mortality are perinatal related: congenital malformations (deformations and chromosomal abnormalities), short gestation and low birth weight-related disorders, and maternal complications.

Objective: This study aims to examine the timeline of how early and at what gestational age (GA) racial disparities for infant mortality begin between Caucasian (C) and African American (AA) infants. It is hypothesized that racial disparities for infant mortality are rooted early on in life at an earlier gestational age.

Design/Methods: This study used de-identified patient data obtained from the Healthcare Cost and Utilization Project (HCUP) from the Agency for Healthcare Research and Quality (AHRQ) for the years 1993-2018. The study included all in-born or transferred-in infants with assigned Caucasian or African American sex/gender for all gestational ages. We compared the odds ratio for mortality among African American and Caucasian infants by sex and GA category. Categorical data were analyzed using the Chi-square test, and continuous variables analyzed using the t-test.

Results: For infants < 32 weeks GA, there is no difference in mortality between C and AA population. AA population has a significantly higher mortality in infants > 33 weeks compared to C population. Male sex had higher mortality compared to females (0.33% vs 0.27%, OR: 0.82 (0.81-0.84), p < 0.01) in the overall population, (0.25% vs 0.20%, OR: 0.83 (0.81-0.84), p < 0.01) in Caucasian infants and (0.62% vs 0.50%, OR 0.81 (0.79-0.83), p < 0.01) among African American infants.Conclusion(s):

African American infants have significantly higher mortality rates than Caucasian infants beginning at 33 weeks gestational age. At ≤ 32 weeks gestational age, there is no difference in mortality between African American and Caucasian infant populations. 

Demographic Characteristics and Outcomes of Study Population
Mortality in African American and Caucasian Infants by Gestational Age