ArticlePediatrics2021
Hospital Quality of Care and Racial and Ethnic Disparities in Unexpected Newborn Complications.
Article in Pediatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Eligible Infants Included in Neonatal Clinical Trials and Reasons for Noninclusion: A Systematic Review.JAMA network open · 2024Pooled it
- Race and Ethnicity of Infants Enrolled in Neonatal Clinical Trials: A Systematic Review.JAMA network open · 2023Pooled it
- "Like I Wasn't There, Except They Knew I Was": A Qualitative Analysis of Latina Perinatal and Postpartum Experiences in Support of Self-care.Maternal and child health journal · 2026Article
- Risk of unexpected newborn complications by day of the week and time of birth in US term singleton births.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- The Association of Hospital Characteristics with Brachial Plexus Birth Injury.Research square · 2026Article
- Are racial and ethnic disparities in brachial plexus birth injuries explained by known risk factors?Journal of perinatology : official journal of the California Perinatal Association · 2025Article
- Maternal Characteristics and Rates of Unexpected Complications in Term Newborns by Hospital.JAMA network open · 2024Article
- Racial and ethnic inequities in the quality of paediatric care in the USA: a review of quantitative evidence.The Lancet. Child & adolescent health · 2024Review
- Maternal Migration Background and Mortality Among Infants Born Extremely Preterm.JAMA network open · 2023Article
- Maternal and neonatal risk-appropriate care: gaps, strategies, and areas for further research.Journal of perinatology : official journal of the California Perinatal Association · 2023Review
- Racial and Ethnic Disparities in Outcomes Among Newborns with Congenital Diaphragmatic Hernia.JAMA network open · 2023Article
- Sociodemographic factors associated with tracheostomy and mortality in bronchopulmonary dysplasia.Pediatric pulmonology · 2023Article
- Critical Care Among Disadvantaged Minority Groups Made Equitable: Trends Throughout the COVID-19 Pandemic.Journal of racial and ethnic health disparities · 2023Article
- Racial Inequity in High-Risk Infant Follow-Up Among Extremely Low Birth Weight Infants.Pediatrics · 2023Article
- Racial disparities in the development of comorbid conditions after preterm birth: A narrative review.Seminars in perinatology · 2022Review
- Analysis of Racial and Ethnic Diversity of Population Served and Imaging Used in US Children's Hospital Emergency Departments.JAMA network open · 2022Article
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Authors and funding
7 authors at 3 institutions in 2 countries.
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Abstract
objectivesTo investigate racial and ethnic differences in unexpected, term newborn morbidity and the influence of hospital quality on disparities.
methodsWe used 2010-2014 birth certificate and discharge abstract data from 40 New York City hospitals in a retrospective cohort study of 483 834 low-risk (term, singleton, birth weight ≥2500 g, without preexisting fetal conditions) neonates. We classified morbidity according to The Joint Commission's unexpected newborn complications metric and used multivariable logistic regression to compare morbidity risk among racial and ethnic groups. We generated risk-standardized complication rates for each hospital using mixed-effects logistic regression to evaluate quality, ranked hospitals on this measure, and assessed differences in the racial and ethnic distribution of births across facilities.
resultsThe unexpected complications rate was 48.0 per 1000 births. Adjusted for patient characteristics, morbidity risk was higher among Black and Hispanic infants compared with white infants (odds ratio: 1.5 [95% confidence interval 1.3-1.9]; odds ratio: 1.2 [95% confidence interval 1.1-1.4], respectively). Among the 40 hospitals, risk-standardized complications ranged from 25.3 to 162.8 per 1000 births. One-third of Black and Hispanic women gave birth in hospitals ranking in the highest-morbidity tertile, compared with 10% of white and Asian American women (
conclusionsBlack and Hispanic women were more likely to deliver in hospitals with high complication rates than were white or Asian American women. Findings implicate hospital quality in contributing to preventable newborn health disparities among low-risk, term births. Quality improvement targeting routine obstetric and neonatal care is critical for equity in perinatal outcomes.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.