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Abstract
To examine temporal trends of NICU admissions in the U.S. by race/ethnicity, we conducted a retrospective cohort analysis using natality files provided by the National Center for Health Statistics at the U.S. Centers for Disease Control and Prevention. A total of 38,011,843 births in 2008–2018 were included. Crude and risk-adjusted NICU admission rates, overall and stratified by birth weight group, were compared between white, black, and Hispanic infants. Crude NICU admission rates increased from 6.62% (95% CI 6.59–6.65) to 9.07% (95% CI 9.04–9.10) between 2008 and 2018. The largest percentage increase was observed among Hispanic infants (51.4%) compared to white (29.1%) and black (32.4%) infants. Overall risk-adjusted rates differed little by race/ethnicity, but birth weight-stratified analysis revealed that racial/ethnic differences diminished in the very low birth weight (< 1500 g) and moderately low birth weight (1500–2499 g) groups. Overall NICU admission rates increased by 37% from 2008 to 2018, and the increasing trends were observed among all racial and ethnic groups. Diminished racial/ethnic differences in NICU admission rates in very low birth weight infants may reflect improved access to timely appropriate NICU care among high-risk infants through increasing health care coverage coupled with growing NICU supply.
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1 The University of Texas Health Science Center, Department of Neurology, McGovern Medical School, Houston, USA (GRID:grid.468222.8)
2 The University of Texas Health Science Center, Division of Management, Policy and Community Health, School of Public Health, Houston, USA (GRID:grid.468222.8)
3 The University of Texas Health Science Center, Department of Biostatistics and Data Science, School of Public Health, Houston, USA (GRID:grid.468222.8)
4 The University of Texas Southwestern Medical Center, Division of Biostatistics, Department of Population and Data Sciences, Dallas, USA (GRID:grid.267313.2) (ISNI:0000 0000 9482 7121)
5 The Dartmouth Institute for Health Policy and Clinical Practice, Hanover, USA (GRID:grid.414049.c); Geisel School of Medicine at Dartmouth, Department of Pediatrics, Hanover, USA (GRID:grid.254880.3) (ISNI:0000 0001 2179 2404)