Short-term prognosis of very-preterm infants of ethnic minorities and Han nationality at high altitude: a single-center, retrospective study

Abstract

Objective

We aimed to analyze the perinatal care of very-preterm infants (VPIs) in plateau areas of China and to explore any differences in short-term outcomes between ethnic minorities and Han nationality.

Methods

VPIs with gestational age (GA) <32 weeks admitted to Qinghai Red Cross Hospital from 1 January 2018 to 31 December 2020 were enrolled. Maternal information, neonatal information, perinatal care and discharge outcomes were retrospectively collected and analyzed.

Results

A total of 302 VPIs were examined, including 143 (47.4%) ethnic minority infants and 159 (52.6%) Han infants. Mothers of ethnic minority infants were significantly younger than those of Han infants (27 y vs. 30 y, p < .001). There were no differences in the incidence of assisted reproduction, multiple pregnancies, maternal hypertension, clinical chorioamnionitis or premature rupture of membranes >18 h between ethnic minority mothers and Han mothers. Lower proportions of cesarean section and incidence of maternal diabetes were observed in ethnic minority mothers than in Han mothers [(9.1 vs.17.6%, p < .05) and (42.7 vs. 57.9%, p < .05, respectively)]. Meanwhile, fewer antenatal steroids were used in minority group than Han group (65.7 vs. 81.1%, p < .05). No significant differences in rates of death, active treatment, necrotizing enterocolitis stage ≥2, moderate-to-severe BPD, and incidence of severe retinopathy of prematurity in VPIs were found between the two groups and in all GA subgroups. Severe neurological injury was significantly less common in the minority newborns than in the Han infants (1.2 vs. 6.1%, p < .05). Compared with Han group, no excess risk of death, death or major morbidity, death despite active treatment, death or major morbidity despite active treatment was observed in ethnic minorities, with or without adjusting for gestational age and prenatal steroids.

Conclusions

Short-term prognosis of VPIs of ethnic minorities were similar to those of Han nationality.

Keywords:

• Preterm
• infants
• ethnic minorities
• prognosis
• China

Ethical approval

The study was approved by the Qinghai Red Cross Hospital Ethics Committee (KY-2021-29). Informed consent was waived by ethics committee because this study was a retrospective analysis of clinical data. Anonymity was maintained by using the identified number instead of the patient’s names. All methods were performed in accordance with the ethical guidelines.

Author contributions

SH, HP, GZ, and YY designed this study. HS HP, YS, FW, CL, and JK collected the data and entered, analyzed, and interpreted the results. SH, HP, YS, KZ, ZY, and YY wrote the manuscript. All authors critically revised and approved the final version of the manuscript.

Data availability statement

The datasets used and/or analyzed during the current study are not publicly available due to the institution restriction but are available from the corresponding author on reasonable request.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.