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The associations between ethnicity and outcomes of infants in neonatal intensive care units
  1. Shanshan Ruan1,
  2. Mohamed E Abdel-Latif2,3,
  3. Barbara Bajuk4,5,
  4. Kei Lui1,6,
  5. Ju Lee Oei1,6,
  6. On behalf of the NSW and the ACT Neonatal Intensive Care Units (NICUs) Group
  1. 1School of Women's and Children's Heath, University of New South Wales, Kensington, New South Wales, Australia
  2. 2Department of Neonatology, Canberra Hospital, Garran, Australian Capital Territory, Australia
  3. 3Division of Women and Child Health, Clinical School, Australian National University, Woden, Australian Capital Territory, Australia
  4. 4NSW Pregnancy and Newborn Services Network, Westmead, New South Wales, Australia
  5. 5School of Public Health, University of Sydney, Sydney, New South Wales, Australia
  6. 6Department of Newborn Care, Royal Hospital for Women, Randwick, New South Wales, Australia
  1. Correspondence to Dr Ju Lee Oei, Department of Newborn Care, Royal Hospital for Women, Barker Street, Randwick, NSW 2031, Australia; ju.oei{at}


Objective To determine the associations between maternal ethnicity and outcomes of infants born between 22 and 31 weeks' gestation and admitted to neonatal intensive care units in New South Wales and the Australian Capital Territory, Australia, between 1995 and 2006.

Design and patients De-identified perinatal and neonatal outcome data for 10 267 infants were examined. There were 8629 (84.0%) Caucasian, 922 (9.0%) Asian, 439 (4.3%) indigenous, 127 (1.2%) Polynesian and Maori (PAM) and 150 (1.5%) infants of other maternal ethnicities (excluded from study). Caucasians were the referent for all comparisons.

Results Infants of indigenous mothers were less likely to receive antenatal steroids and three times as likely to be born in non-tertiary hospitals (OR 3.28, 95% CI 2.59 to 4.16, p<0.001). PAM infants were more likely to have Apgar scores <7 at 5 min of age (1.76, 95% CI 1.16 to 2.67, p<0.01). Asian infants had lower birth weight (mean±SD 44.7±27.9, p<0.001) and head circumference percentiles (47.8±29.0, p<0.001), were more likely to be small for gestational age (1.53, 95% CI 1.25 to 1.88, p<0.001), less likely to have hyaline membrane disease (0.78, 95% CI 0.68 to 0.90, p<0.001) but had a higher risk of severe retinopathy of prematurity (1.52, 95% CI 1.11 to 2.07, p<0.01). Ethnicity did not influence infant mortality.

Conclusions Neonatal growth characteristics and morbidity but not mortality are influenced by maternal ethnicity. Of concern is the risk of low Apgar scores in PAM infants and non-tertiary births of indigenous infants. Review of perinatal care for certain vulnerable ethnic populations is recommended due to the rapidly changing ethnic compositions of many countries around the world.

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  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the NSW Population Health Human Research Ethics Committee, Australia.

  • Provenance and peer review Not commissioned; externally peer reviewed.