Bronchopulmonary Dysplasia in Asian American, Native Hawaiian, and Pacific Islander Infants with Very Low Birth Weight in California

OBJECTIVE: To characterize incidences of bronchopulmonary dysplasia (BPD) and oxygen use at discharge in infants with very low birth weight by Asian American, Native Hawaiian, and Pacific Islander (AANHPI) ethnicity. STUDY DESIGN: We studied infants with very low birth weight born in California from 2012 to 2019. Infants of AANHPI mothers were studied in aggregate, were disaggregated by maternal ethnicity, and were compared with infants of Black, Hispanic, and non-Hispanic White (NHW) mothers. BPD was defined as the use of supplemental oxygen at 36 weeks postmenstrual age. Multivariable generalized estimating equation Poisson regression models adjusting for infant, maternal, and hospital-level factors compared outcomes across racial and ethnic groups using NHW as the reference. RESULTS: We studied 29 467 infants whose mothers self-identified as AANHPI (n = 5002), Black (n = 3711), Hispanic (n = 14 168), and NHW (n = 6586). In infants of AANHPI mothers, incidences of BPD and oxygen use at discharge were 24.9% (disaggregated range: 16.9%-30.5%) and 9.2% (disaggregated range: 5.8%-14.5%), respectively. Compared with infants of NHW mothers, infants of Asian Indian mothers had a significantly lower risk of BPD (adjusted relative risk [aRR] 0.71) and oxygen use at discharge (aRR 0.66), whereas infants of Chinese and Korean mothers had a significantly higher risk of BPD (aRR 1.28 and aRR 1.45, respectively) and oxygen use at discharge (aRR 1.46 and aRR 1.77, respectively). CONCLUSIONS: AANHPI data disaggregation demonstrated variability in incidences of BPD and oxygen use at discharge, and variability in risk compared with infants of NHW mothers. Our study highlights disparities across this diverse group that is typically studied in aggregate.