729 - Bronchopulmonary Dysplasia in Very Low Birth Weight Asian American, Native Hawaiian, and Pacific Islander Infants in California

Publication Number: 729.4104

Kalen Hendra, Stanford University School of Medicine, Redwood CIty, CA, United States; Xin Cui, Stanford University School of Medicine, Palo Alto, CA, United States; Jochen Profit, Stanford University School of Medicine, Palo Alto, CA, United States

Background: Data aggregation of Asian American, Native Hawaiian, and Pacific Islander (AANHPI) infants may obscure disparities in the incidence rates of bronchopulmonary dysplasia (BPD) and related respiratory outcomes.

Objective: To characterize the incidence of bronchopulmonary dysplasia (BPD) and related respiratory outcomes in very low birth weight (VLBW) AANHPI infants.

Design/Methods: We studied 29,467 VLBW (born at 22-29 weeks gestation or birth weight 401-1500 grams) infants born in California from 2012-2019. AANHPI infants were studied in aggregate and disaggregated by maternal race and ethnicity. BPD was defined as the receipt of supplemental oxygen at 36 weeks. Population characteristics and BPD-related outcomes were presented using proportions for each racial and ethnic group. Multivariable logistic regression models adjusted for infant, maternal, and hospital-level factors were used to compare outcomes and measures across racial and ethnic groups using Non-Hispanic White (NHW) as the reference.

Results: The AANHPI aggregate had a 24.9% incidence of BPD and a 9.2% incidence of oxygen use at discharge. Compared to NHW infants, Asian Indian infants had a lower risk of BPD (adjusted relative risk (aRR) 0.71, 95% confidence interval (CI): 0.60 to 0.83) and oxygen use at discharge (aRR 0.66, 95% CI: 0.47 to 0.93). In contrast, Chinese and Korean infants had a higher risk of BPD (aRR 1.28, 95% CI: 1.07 to 1.52 and aRR 1.45, 95% CI: 1.16 to 1.80, respectively) and oxygen use at discharge (aRR 1.46, 95% CI: 1.08 to 1.97 and RR 1.77, 95% CI: 1.23 to 2.55, respectively).

Conclusion(s): Disaggregation of AANHPI data demonstrated variability in the incidence of BPD and oxygen use at discharge, highlighting existing disparities in health outcomes amongst the AANHPI ethnic groups.

Table 1. BPD and Related Respiratory Outcomes by Maternal Race and Ethnicity.
Disaggregation of the AANHPI population demonstrates variability in the incidence of BPD and oxygen use at discharge. Native Hawaiian and Asian Indian infants had the lowest rates of BPD. Asian Indian and Laotian, Thai, Hmong, and Cambodian infants had the lowest rates of oxygen use at discharge.

Figure 1. Relative Risk of BPD Adjusted for Infant, Maternal, and NICU Factors.
Disaggregation of the AANHPI population demonstrates that compared to NHW infants, Asian Indian infants have a lower risk of BPD and Chinese and Korean infants have a higher risk of BPD. LTHC: includes Laotian, Thai, Hmong, and Cambodian; Other Asian: includes other specified/unspecified Asian; A/nA multiple: Asian and non-Asian multiple; Other PI: other Pacific Islander.

Figure 2. Relative Risk of Oxygen Use at Discharge Adjusted for Infant, Maternal, and NICU Factors.
Disaggregation of the AANHPI population demonstrates that compared to NHW infants, Asian Indian infants have a lower risk of oxygen use at discharge and Chinese and Korean infants have a higher risk of oxygen use at discharge. LTHC: includes Laotian, Thai, Hmong, and Cambodian; Other Asian: includes other specified/unspecified Asian; A/nA multiple: Asian and non-Asian multiple; Other PI: other Pacific Islander.

Table 1. BPD and Related Respiratory Outcomes by Maternal Race and Ethnicity.
Disaggregation of the AANHPI population demonstrates variability in the incidence of BPD and oxygen use at discharge. Native Hawaiian and Asian Indian infants had the lowest rates of BPD. Asian Indian and Laotian, Thai, Hmong, and Cambodian infants had the lowest rates of oxygen use at discharge.

Figure 1. Relative Risk of BPD Adjusted for Infant, Maternal, and NICU Factors.
Disaggregation of the AANHPI population demonstrates that compared to NHW infants, Asian Indian infants have a lower risk of BPD and Chinese and Korean infants have a higher risk of BPD. LTHC: includes Laotian, Thai, Hmong, and Cambodian; Other Asian: includes other specified/unspecified Asian; A/nA multiple: Asian and non-Asian multiple; Other PI: other Pacific Islander.

Figure 2. Relative Risk of Oxygen Use at Discharge Adjusted for Infant, Maternal, and NICU Factors.
Disaggregation of the AANHPI population demonstrates that compared to NHW infants, Asian Indian infants have a lower risk of oxygen use at discharge and Chinese and Korean infants have a higher risk of oxygen use at discharge. LTHC: includes Laotian, Thai, Hmong, and Cambodian; Other Asian: includes other specified/unspecified Asian; A/nA multiple: Asian and non-Asian multiple; Other PI: other Pacific Islander.