Racial and Ethnic Variation in Outpatient Respiratory Outcomes in Bronchopulmonary Dysplasia.

Abstract

To examine racial and ethnic variation in outpatient respiratory outcomes among children with bronchopulmonary dysplasia (BPD) cared for in multidisciplinary clinics. Subjects born <32 weeks' gestation with subsequent BPD were recruited through the BPD Collaborative Registry. Data were collected via questionnaire. Associations between outpatient respiratory outcomes and race and ethnicity were assessed using multivariable regression. Among 1564 subjects across 15 BPD clinics, 30.6% were caregiver-identified as Black/African American and 12.1% as Hispanic, which were higher proportions than observed in preterm populations of the respective states where the clinics were located. Compared with non-Hispanic White subjects, Black/African American and Hispanic subjects had younger gestational ages, lower birth weights, and longer initial hospitalizations and were more likely to be insured by Medicaid. Both Black/African American and Hispanic subjects were significantly more likely to be seen in the emergency department or readmitted for respiratory reasons than non-Hispanic White subjects (aORs 1.54, P = .001 and 1.99, P < .001, respectively). Hispanic subjects were also more likely to have sick visits (aOR: 1.52, P = .016). Both Black/African American and Hispanic children are disproportionately represented in BPD clinics and have a higher likelihood of acute care use, compared with non-Hispanic White children. To optimize respiratory health outcomes of all children with BPD, further research is needed to identify factors that drive observed racial and ethnic differences.