Preterm infants may be born with underdeveloped lungs that need a significant amount of support. This need may continue for the baby’s first months of life outside the womb. Some conditions are quite common – and often easily treated – such as respiratory distress syndrome. Other conditions are more significant. And, it turns out, an infant’s race may contribute to the likelihood the baby will survive. We like to think that race does not matter, but it turns not that not all premature patients are treated the same.
A recent study published in the Journal of the American Medical Association evaluated premature infants born with bronchopulmonary dysplasia (BPD). BPD affects approximately half of all infants born at less than 30 weeks. BPD develops in underweight premature babies who receive oxygen under pressure, like through a ventilator. Though the lungs need oxygen to develop, the forced oxygen irritates and injures the air sacs in the lungs. This irritation can become a chronic condition that interferes with the lungs’ ability to exchange CO2 and oxygen.
Researchers reviewed the outcomes of 834 infants with severe BPD at different medical centers. They found that infants born to Black mothers were twice as likely to experience death (6% v. 3%) and had, on average, a longer hospital stay than infants born to White mothers (130 days v 121 days). What is behind these dramatic differences?
The researchers noted that “disparate outcomes in neonatal morbidities have been attributed to biologic differences between Black and White patients. Growing evidence indicates that disparate outcomes are non-biologic in nature.” The researchers also “posit that the results of our study reflect structural differences in the experience of Black families and the care that Black infants receive in the intensive care unit setting. Structural racism is a root cause for the increased rates of life struggles that Black families in the NICU face.” Further studies are being planned to resolve potentially confounding aspects such as income disparities.
As attorneys representing families who have suffered an injustice, it is difficult to assign the cause to disparate treatment due to race. But race exists in the background of our cases, just as it exists in the background in medicine.
