the differential effects of maternal age, raceethnicity and insurance on neonatal intensive care unit admission rates的微分影响产妇年龄,raceethnicity和保险在新生儿重症监护室住院率.pdf

de Jongh et al. BMC Pregnancy and Childbirth 2012, 12:97 /1471-2393/12/97 RESEARCH ARTICLE Open Access The differential effects of maternal age, race/ethnicity and insurance on neonatal intensive care unit admission rates Beatriz E de Jongh1,5*†, Robert Locke2,3†, David A Paul2,3† and Matthew Hoffman4† Abstract Background: Maternal 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. Methods: The 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. Results: AMA 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. Conclusions: Private 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