For infants born extremely preterm, redirection-of-care discussions occurred less often for Black, Hispanic infants
For infants born extremely preterm, redirection-of-care discussions occur less often for Black and Hispanic infants, according to a study published online March 11 in JAMA Pediatrics.
Jane E. Brumbaugh, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues examined associations between maternal social determinants of health and redirection-of-care discussions in a retrospective analysis of a prospective cohort of infants born at less than 29 weeks of gestation. The infants received active treatment at birth.
The researchers found that 15 percent of the 15,629 infants from 13,643 mothers had documented redirection-of-care discussions. The percentage of infants with redirection-of-care discussions did not differ significantly by race (15 percent Black; 15 percent White) or ethnicity (14 percent Hispanic; 15 percent non-Hispanic) in unadjusted comparisons. After adjustment for maternal and neonatal factors, infants whose mothers identified as Black or Hispanic were less likely than those who identified as White or non-Hispanic to have documented redirection-of-care discussions (adjusted odds ratios, 0.84 and 0.72, respectively). There was no difference seen in redirection-of-care discussion occurrence by maternal education level or insurance type.
“Our findings suggest the possibility that race and ethnicity may be relevant to goals of care discussions and end-of-life care in the neonatal intensive care setting, and further study in this area is needed,” the authors write.
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