Inequities in prenatal neonatology consultation in high-mortality neonatal populations.

OBJECTIVES

To explore inequities in prenatal consultation and parental resuscitation decisions across high-mortality conditions.

STUDY

DESIGN

We conducted a retrospective chart review of pregnant people whose liveborn neonates were diagnosed with high-mortality conditions. We examined two cohorts: periviable infants (22 0/7-24 6/7 weeks) and infants with severe congenital anomalies.

RESULTS

A total of 194 neonates met eligibility criteria for the periviable cohort, 197 for the congenital anomaly cohort. In the periviable cohort, 94% of White vs. 81% of Black pregnant people received neonatology consultation (p = 0.009). A total of 96% of those with commercial insurance vs. 82% of those with Medicaid received consultation (p = 0.005). Half of Hispanic pregnant people did not receive neonatology consultation (p = 0.02). In the congenital anomaly cohort, pregnant people who spoke a language other than English were less likely to receive consultation (44% vs. 81%, p = 0.02).

CONCLUSIONS

This regional assessment found previously unrecognized inequities in prenatal neonatology consultation.