• Press Release

Race, Hospital, and Premature Babies Outcomes

Mount Sinai Researchers Find Differences in Very Preterm Infant Morbidity and Mortality Rates among New York City Hospitals

  • New York, NY
  • (January 02, 2018)

Among very premature infants, black and Hispanic babies are more likely than white babies to be born at hospitals with higher rates of death and complications, researchers at the Icahn School of Medicine at Mount Sinai report. These differences in hospital quality are an important and potentially modifiable cause of racial disparities in neonatal deaths and severe complications.

The study, titled “Differences in Morbidity and Mortality Rates in Black, White and Hispanic Very Preterm Infants Among New York City Hospitals,” was published in an online study today in JAMA Pediatrics.  For a video about this study click here.

The Mount Sinai researchers found that very premature black and Hispanic infants were more likely to be born at hospitals with higher risk-adjusted neonatal morbidity-mortality rates, and that these differences contributed to excess morbidity and mortality among the black and Hispanic infants. These differences in hospital of birth explained 39.9 percent of the black-white disparity and 29.5 percent of the Hispanic-white disparity in outcomes.

According to Elizabeth Howell, MD, Director of the Women’s Health Institute, Icahn School of Medicine at Mount Sinai, and lead author of the study, neonatal care has improved substantially over the past decade, yet racial and ethnic disparities in morbidity and mortality continue.

“It is very important to seriously think about the cause for the severe preterm babies’ morbidities and how it will affect these children later on in life,” said Dr. Howell. “When a baby is born prematurely, many complications can occur—they can have problems with their lungs, eyes, intestines, and brain, which will affect them later on in life. The real focus here is to try to reduce morbidity in preterm babies and give these kids a chance at a healthier life.”

Howell and her team of researchers also found that the risk-standardized morbidity-mortality rate was twice as high for preterm infants born in hospitals in the highest morbidity-mortality tertile versus those born in hospitals with the lowest morbidity-mortality. Pregnancy normally lasts about 40 weeks, and babies born after 37 weeks are considered full term. The study focused on the most vulnerable preterm infants, delivered from 24 to 31 completed weeks’ gestation.

The researchers examined 7,177 very preterm infants from 39 New York City hospitals and found that 28 percent of the babies died or experienced serious complications between the years 2010-2014.  Compared to white infants, however, black and Hispanic infants were more likely to die or have severe heath issues.  

The study measured the composite of mortality (neonatal or in-hospital up to a year after birth)  and severe morbidity. A risk-adjusted neonatal morbidity-mortality rate was generated for very preterm infants in each hospital. Hospitals were ranked using this measure, and differences in the distribution of black, Hispanic, and white very preterm births were assessed among the hospitals.

“This study shines light on the idea that we really need to focus on narrowing disparities when we think about hospital quality improvement,” said Dr. Howell. “Additionally, these disparities are not just local to New York City. We know that there are infant and neonatal racial and ethnic disparities that have been longstanding in this country.”

This study was supported by award R01HD078565 from the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health.

Also making key research contributions from Mount Sinai were Teresa Janevic, PhD, MPH; Natalia N. Egorova, PhD, MPH; and Amy Balbierz, MPH. Adjunct Mount Sinai Faculty include Paul L. Hebert, PhD and  Jennifer Zeitlin, DSc, MA.

About the Mount Sinai Health System

Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, over 400 outpatient practices, nearly 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.

Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,300 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in several pediatric specialties.

For more information, visit https://www.mountsinai.org or find Mount Sinai on Facebook, Twitter and YouTube.

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