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Am J Perinatol 2020; 37(02): 166-173
DOI: 10.1055/s-0039-1688481
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Disparities in Health Care–Associated Infections in the NICU

Jessica Liu
1   Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Lucile Packard Children's Hospital, Stanford University School of Medicine, Palo Alto, California
2   California Perinatal Quality Care Collaborative, Palo Alto, California
,
Charlotte Sakarovitch   *
3   Division of Biomedical Informatics Research, Department of Medicine, Stanford University, Stanford, California
4   Medical Data Lab, Université Côte d'Azur, Nice, France
,
Krista Sigurdson
1   Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Lucile Packard Children's Hospital, Stanford University School of Medicine, Palo Alto, California
2   California Perinatal Quality Care Collaborative, Palo Alto, California
,
Henry C. Lee
1   Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Lucile Packard Children's Hospital, Stanford University School of Medicine, Palo Alto, California
2   California Perinatal Quality Care Collaborative, Palo Alto, California
,
Jochen Profit
1   Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Lucile Packard Children's Hospital, Stanford University School of Medicine, Palo Alto, California
2   California Perinatal Quality Care Collaborative, Palo Alto, California
› Author Affiliations Funding The authors are supported by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01 HD083368-01 and R01 HD08467-01, PI Profit; K23HD068400). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health and Human Development or the National Institutes of Health.
Further Information

Publication History

17 December 2018

17 March 2019

Publication Date:
30 April 2019 (online)

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Abstract

Objectives This study aimed to examine multilevel risk factors for health care–associated infection (HAI) among very low birth weight (VLBW) infants with a focus on race/ethnicity and its association with variation in infection across hospitals.

Study Design This is a population-based cohort study of 20,692 VLBW infants born between 2011 and 2015 in the California Perinatal Quality Care Collaborative.

Results Risk-adjusted infection rates varied widely across neonatal intensive care units (NICUs), ranging from 0 to 24.6% across 5 years. Although Hispanic infants had higher odds of HAI overall, race/ethnicity did not affect the variation in infection rates. Non-Hispanic black mothers were more likely to receive care in NICUs within the top tertile of infection risk. Yet, among NICUs in this tertile, infants across all races and ethnicities suffered similar high rates of infection.

Conclusion Hispanic infants had higher odds of infection. We found significant variation in infection across NICUs, even after accounting for factors usually associated with infection.

Keywords

infant - health care–associated infection - disparity - risk factors

* At the time of this research, Dr. Sakarovitch was a senior statistician at the quantitative sciences unit.


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