New Study Examines Racial Inequities In Quality of Care In California’s Neonatal Intensive Care Units

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African-American babies were less likely to suffer a collapsed lung, and grew faster than white babies, according the study. (Photo by ER Productions Ltd/Getty Images)

The quality of care infants receive in California neonatal intensive care units could be linked to their race or ethnicity, a new study by Stanford University’s School of Medicine suggests.

The study, published in the journal of American Academy of Pediatrics on Monday, Aug. 28, found that Asian-American and white infants got the highest quality of overall care. African-American infants received slightly lesser quality of care, according to the score system used in the analysis, while Hispanic infants and those described as “other” (American Indian and Alaskan Native infants) received the lowest quality of care.

“Significant racial and/or ethnic differences in quality between and within NICUs are a troubling finding,” authors of the study wrote.

Researchers examined the quality of care for close to 19,000 infants in 134 NICUs across California (90 percent of all units in the state) who were born between 2010 and 2014, the San Francisco Gate reported. The study is the first of its kind to analyze the inequality of care across multiple dimensions of neonatal intensive care at the same time.

Using a composite index known as Baby-Monitor, which includes nine measures of quality of care for infants, researchers reviewed whether the newborns and/or their mothers received specific treatments before or after their stay, and if they developed harmful conditions after leaving the unit. Some of these treatments and conditions include eye exams, bacterial and fungal infections, antenatal steroid administration and lung disease.

The study found that Black and Latino infants were less likely to receive antenatal steroids, which are given to pregnant women who are expected to deliver early. These babies were also less likely to undergo an eye exam or receive breast milk after leaving the hospital.

However, African-American babies were less likely to suffer a collapsed lung, and grew faster compared to white babies, according to the analysis.

These racial disparities aren’t always clear-cut, however.

Though white infants scored higher than Black and Latino infants in most areas measuring quality of care, there were some measures where Black and Latino infants actually scored better than whites. Also, in some NICUs, white babies received better care than Black and Latino babies, but in other units, the opposite was true.

“On a population basis, there are general trends: the higher proportion of African-American or Hispanic infants in an NICU, the lower the overall quality scores tend to be,” Dr. Jochen Profit, one of the study’s co-authors, told the San Francisco Gate. “But even there, there’s a lot of variation where some hospitals we think of as serving a really vulnerable population actually are among the better performers in the state.”

Overall, the hospitals with the highest quality care delivered better care to white newborns, according to the study. On the flip side, African-American and Latino newborns were more likely than white infants to receive quality care at lower-quality NICUs.

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