Exploring Racial Disparities in Neonatal Intensive Care Unit Admissions [ID 1692]

INTRODUCTION: Neonatal intensive care unit (NICU) admissions disrupt parental–child bonding and breastfeeding and affect parental mental health. We examined risk factors for NICU admission to investigate disparities in admission rates. METHODS: We collected demographic, obstetric, and neonatal factors from electronic medical records from full-term, singleton neonates without anomalies born during 2019 at our urban, academic hospital. We performed univariate and multivariable logistic regressions predicting NICU stay from self-reported maternal race, indication for delivery, and APGAR score and additional factors. RESULTS: Our study includes 1,666 neonates; 328 (20%) were admitted to NICU, 842 (52%) self-identified as Black, and 405 (25%), as Hispanic. As compared to other groups, neonates identified as Black were more likely to be admitted to the NICU (X2(1)=8.68, P <.01), born at an earlier gestational age (39.0 versus 39.2 weeks, P <.0001), and delivered for fetal indication (X2(9)=17.59, P <.05). No significant differences in respiratory distress at delivery or NICU length of stay were found across race. Although color APGAR score differed significantly, overall categorical (less than 7) APGAR showed no difference across groups. In multivariable logistic regression, those who were identified as Black, compared to all others, predicted increased odds of NICU admission even when controlling for several measured covariates (odds ratio 1.48; 95% CI, 1.01–2.15). CONCLUSIONS/IMPLICATIONS: Our findings reproduce known disparities in NICU admissions and designation of APGAR scores. Additional research is needed to further explore underlying pathologies associated with the increased NICU admission rates among neonates identified as Black given similar length of stay and respiratory distress across groups.