Neonatal mortality among disaggregated Asian American and Native Hawaiian/Pacific Islander populations

Isabelle Nguyên Ý Maricar; Daniel Helkey; Santhosh Nadarajah; Risa Akiba; Adrian Matias Bacong; Sheila Razdan; Latha Palaniappan; Ciaran S Phibbs; Jochen Profit

doi:10.1038/s41372-024-02149-1

Neonatal mortality among disaggregated Asian American and Native Hawaiian/Pacific Islander populations

J Perinatol. 2024 Oct 13. doi: 10.1038/s41372-024-02149-1. Online ahead of print.

Authors

Isabelle Nguyên Ý Maricar^{1

2}, Daniel Helkey^{3

4}, Santhosh Nadarajah^{5

6}, Risa Akiba^{5

7}, Adrian Matias Bacong^{5

8}, Sheila Razdan³, Latha Palaniappan^{5

8}, Ciaran S Phibbs^#^{3

9}, Jochen Profit^#^{3

4}

Affiliations

¹ Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, CA, USA. [email protected].
² Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC, USA. [email protected].
³ Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
⁴ California Perinatal Quality Care Collaborative, Palo Alto, CA, USA.
⁵ Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, CA, USA.
⁶ Department of Molecular Biology, Princeton University, Princeton, NJ, USA.
⁷ Department of Statistics, University of Chicago, Chicago, IL, USA.
⁸ Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA.
⁹ Health Economics Resource Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.

^# Contributed equally.

PMID: 39397056
DOI: 10.1038/s41372-024-02149-1

Abstract

Objective: We compared neonatal (<28 days) mortality rates (NMRs) across disaggregated Asian American and Native Hawaiian/Pacific Islander (AANHPI) groups using recent, national data.

Study design: We used 2015-2019 cohort-linked birth-infant death records from the National Vital Statistics System. Our sample included 61,703 neonatal deaths among 18,709,743 births across all racial and ethnic groups. We compared unadjusted NMRs across disaggregated AANHPI groups, then compared NMRs adjusting for maternal sociodemographic, maternal clinical, and neonatal risk factors.

Results: Unadjusted NMRs differed by over 3-fold amongst disaggregated AANHPI groups. Native Hawaiian/Pacific Islander neonates in aggregate had the highest fully-adjusted odds of mortality (OR: 1.08 [95% CI: 0.89, 1.31]) compared to non-Hispanic White neonates. Filipino, Asian Indian, and Other Asian neonates experienced significant decreases in odds ratios after adjusting for neonatal risk factors.

Conclusion: Aggregating AANHPI neonates masks large heterogeneity and undermines opportunities to provide targeted care to higher-risk groups.

Abstract

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