The differential effects of maternal age, race/ethnicity and insurance on neonatal intensive care unit admission rates

BMC Pregnancy and Childbirth

Research Article

Beatriz E de Jongh¹  David A Paul²  Robert Locke²  Matthew Hoffman³ 

[1] Department of Neonatal-Perinatal Medicine, St. Christopher’s Hospital for Children, Philadelphia, PA, USA;Division of Neonatal-Perinatal Medicine, St. Christopher’s Hospital for Children, Philadelphia, PA, USA;Department of Neonatology, Christiana Care Health System, Newark, DE, USA;Department of Pediatrics, Thomas Jefferson University, Philadelphia, PA, USA;Department of Obstetrics and Gynecology, Christiana Care Health System, Newark, DE, USA;

关键词: Preterm Birth;    Private Insurance;    Assisted Reproductive Technology;    Birth Outcome;    Adverse Pregnancy Outcome;   

DOI  :  10.1186/1471-2393-12-97

 received in 2011-12-18, accepted in 2012-08-20,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundMaternal race/ethnicity, age, and socioeconomic status (SES) are important factors determining birth outcome. Previous studies have demonstrated that, teenagers, and mothers with advanced maternal age (AMA), and Black/Non-Hispanic race/ethnicity can independently increase the risk for a poor pregnancy outcome. Similarly, public insurance has been associated with suboptimal health outcomes. The interaction and impact on the risk of a pregnancy resulting in a NICU admission has not been studied. Our aim was, to analyze the simultaneous interactions of teen/advanced maternal age (AMA), race/ethnicity and socioeconomic status on the odds of NICU admission.MethodsThe Consortium of Safe Labor Database (subset of n = 167,160 live births) was used to determine NICU admission and maternal factors: age, race/ethnicity, insurance, previous c-section, and gestational age.ResultsAMA mothers were more likely than teenaged mothers to have a pregnancy result in a NICU admission. Black/Non-Hispanic mothers with private insurance had increased odds for NICU admission. This is in contrast to the lower odds of NICU admission seen with Hispanic and White/Non-Hispanic pregnancies with private insurance.ConclusionsPrivate insurance is protective against a pregnancy resulting in a NICU admission for Hispanic and White/Non-Hispanic mothers, but not for Black/Non-Hispanic mothers. The health disparity seen between Black and White/Non-Hispanics for the risk of NICU admission is most evident among pregnancies covered by private insurance. These study findings demonstrate that adverse pregnancy outcomes are mitigated differently across race, maternal age, and insurance status.

【 授权许可】

CC BY   
© de Jongh et al.; licensee BioMed Central Ltd. 2012