Comparison of Pulmonary Maturation Differences Among Black and White Infants

BACKGROUND: Bias exists that infants of color have better outcomes in the neonatal intensive care unit compared to White infants. These presumptions stem from perceived differences in pulmonary maturation between Black and White infants. PURPOSE: To compare the incidence of respiratory morbidity in Black and White infants, and to identify if pulmonary maturation differences exist. DATA SOURCES: Databases included MEDLINE (Ovid), Embase (Elsevier), and Web of Science (Clarivate). STUDY SELECTION: All identified studies were uploaded into Covidence. A total of 2124 citations were screened in the abstract phase. Study selection was carried out independently by 2 authors and excluded if did not meet inclusion criteria. Disagreements were resolved by adjudication by third reviewer. Article selection presented by flowchart as per PRISMA guidelines. DATA EXTRACTION: A citation tracking system was used to identify relevant studies included in the full text review. RESULTS: Though differences among Black and White infants were present, it was not found that race alone had a causal impact on an infant's pulmonary maturation, but rather that these differences in outcomes could be related to health disparities impacted by race. IMPLICATIONS FOR PRACTICE AND RESEARCH: As providers driving care and making treatment decisions for neonatal patients, we must be aware of our implicit biases regarding neonatal lung development. Additional research is essential to drive policy change and ensure equitable healthcare and reduce infant mortality and morbidity.