Association of Asian American, Native Hawaiian, and Pacific Islander Very Low Birth Weight infants’ Outcomes with Neonatal Intensive Care Unit Cultural Familiarity

Abstract Objective: To assess whether cultural familiarity, measured by Asian American, Native Hawaiian, and Pacific Islander (AANHPI) hospital patient volume, is associated with care and outcomes among very low birth weight infants. Study Design: We analyzed 43,067 infants, including 6,534 (15.2%) AANHPI infants, from 142 California neonatal intensive care units (NICUs) in the California Perinatal Quality Care Collaborative database (2011–2019). Hospitals were grouped into tertiles by AANHPI VLBW admissions. Outcomes were assessed using multivariable Poisson regression adjusted for infant, maternal, and hospital factors. Result: Compared to low-tertile NICUs, AANHPI infants in high- and middle-tertile NICUs had greater human milk use at discharge (79.2% and 77.0% vs. 69.6%, p<.001), and those in high-tertile NICUs had higher growth velocity (13.3 vs. 12.8 g/kg/day, p<.001), although attenuated after adjustment. Mortality and major morbidities showed no association with AANHPI patient volume. Conclusion: Higher AANHPI patient volume was linked to feeding outcomes but not broader neonatal outcomes.