Fewer premature babies are dying overall, thanks to improvement in care across all racial and ethnic groups, a new analysis has found. File Photo by agnumohansson/Shutterstock
June 10 (UPI) -- Racial disparities in the care received by babies born prematurely -- and with low birth weight -- and their mothers might be narrowing and generating improvements in overall survival, a study published Wednesday has found.
The improvements in care have led to increases in overall survival among babies born prematurely, and that in-hospital mortality for preterm infants is comparable among racial and ethnic groups, researchers report in the study, published in JAMA Network Open.
For the study, researchers at 16 universities, including the University of Alabama-Birmingham, with RTI International, the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, analyzed data on more than 20,000 preterm infants born between 2002 and 2016.
In-hospital death rates among black infants born prematurely dropped to 24 percent in 2016 from 35 percent in 2002, compared to a decline to 27 percent from 32 percent for Hispanic infants and to 22 percent from 30 percent for white infants, the researchers found.
Past research has suggested that death rates for black and Hispanic infants born prematurely were twice those of white infants.
"There were narrowing racial/ethnic disparities in key interventions, including receipt of antenatal corticosteroids and cesarean delivery" over the study period, the study authors wrote in explaining the trends.
"Adherence to evidence-based medicine and continued quality improvement efforts should further improve outcomes of extremely preterm infants among all racial and ethnic groups," said the authors, who did not respond to requests for comment.
Overall, about 10 percent of all babies in the United States are born prematurely, according to the Centers for Disease Control and Prevention. Roughly one-third of preterm infants die, the agency estimates.
Common causes of death in preterm infants include breathing problems, sepsis and neurodevelopmental issues, among others, according to the March of Dimes.
Roughly 40 percent of the infants included in the new analysis were black, while 40 percent were white and 20 percent were Hispanic.
Rates of late-onset sepsis among black infants declined to 24 percent in 2016 from 37 percent in 2002, and to 23 percent from 45 percent among Hispanic infants, compared to a drop to 25 percent from 36 percent among white infants, the authors found.
In all, 90 percent of black infants born prematurely in 2016 received corticosteroids -- which are administered to treat breathing problems and promote lung development -- up from 72 percent in 2002. Similarly, 83 percent of preterm Hispanic infants received the drugs in 2016, compared to 73 percent in 2002, they said.
Rates of cesarean delivery also increased among preterm black infants -- to 59 percent from 45 percent -- and preterm Hispanic infants -- to 59 percent from 49 percent -- over the study period, the researchers reported. Cesarean deliveries among preterm white infants held steady at just over 60 percent, they said.
Narrowing racial and ethnic disparities in care, including the use of corticosteroids and cesarean delivery, likely led to declines in death rates among preterm black and Hispanic infants, the researchers said.
"This ... study found no racial/ethnic differences in changes in mortality rates or most major morbidities among extremely preterm infants, with mortality decreasing over time across all groups," they wrote.