Differential transport patterns by race and ethnicity in very low birth weight infants.

OBJECTIVE: To determine how the likelihood of acute transfer for very low birth weight (VLBW) infants differs by race and ethnicity. STUDY DESIGN: This retrospective cohort study used data for VLBW, preterm ( < 37 weeks) infants <28 days old born between 2012 and 2018 to identify acute inter-hospital transports between hospitals in California. We calculated the odds ratio for acute transport for each race and ethnicity (non-Hispanic White, non-Hispanic Black, Asian American/Native Hawaiian/Pacific Islander [AANHPI], and Hispanic), controlling for network, hospital, maternal sociodemographic, and infant clinical characteristics. RESULT: AANHPI infants were significantly less likely to be transported compared to non-Hispanic White infants (OR 0.85; p = 0.01) after risk adjustment. Hospital-level factors (e.g. NICU level) were most significantly associated with transfer likelihood. CONCLUSION: The likelihood of acute transfer for VLBW infants differs by race and ethnicity, which may reflect underlying inequities and implicit biases in the system of care.