Photo Credit: Herjua
The following is a summary of “Disparities in Survival Without Major Morbidity Among Very Low Birth Weight Infants in California,” published in the November 2024 issue of Pediatrics by Liu et al.
Very low birth weight (VLBW) infants are more susceptible to adverse outcomes in the neonatal intensive care unit (NICU), with survival without significant morbidity being a key outcome of care.
Researchers conducted a retrospective study to examine whether improvements in survival without significant morbidity were equitable across racial and ethnic groups.
They included 66,786 infants with a birth weight <1500 grams or gestational age <29 weeks cared for (January 1, 2008, and December 31, 2021), using the California Perinatal Quality Care Collaborative (CPQCC) database. Survival without significant morbidity was examined over time, stratified by safety net NICUs (snNICUs) and racial and ethnic groups.
The results showed survival without significant morbidity increased from 62.2% to 66.1% (P<.001) between 2008 and 2021, with improvement plateauing after 2017. Native Hawaiian/Pacific Islander (NH/PI) and Black infants had the largest improvements (12.4% and 9.8%, respectively). However, Hispanic infants had the lowest survival rates (64.3%) in the last 3 years, compared to non-Hispanic white (NHW) (67.6%), Black (67.8%), Asian (68.9%), NH/PI (68.5%), and American Indian/Alaskan Native (AI/AN) (69.9%) infants. Black and Hispanic infants were more likely to be cared for in snNICUs, which had lower survival rates without significant morbidity than non-snNICUs at all time points.
They concluded that while survival without significant morbidity improved over 14 years, progress stalled in recent years, with ongoing inequities, particularly in snNICUs, warranting further attention.
