Race and Ethnicity and Disparities in Neonatal Outcomes in Twin Pregnancies [ID: 1375610]

INTRODUCTION: Twin pregnancies are associated with adverse neonatal outcomes. We aimed to investigate disparities in neonatal outcomes by maternal race and ethnicity. METHODS: This was an IRB-approved, retrospective cohort of twin deliveries at a single institution between 2001 and 2018. Pregnancies delivered less than 23 weeks’ gestational age (GA), fetal demise, or major anomaly were excluded. The primary exposure, race and ethnicity, was self-reported as follows: non-Hispanic White, Hispanic, non-Hispanic Black, Asian/Pacific Islander, and other/mixed race. The primary outcome was neonatal intensive care unit (NICU) admission of at least one twin. Secondary outcomes included 5-minute Apgar less than 7 for either twin, GA at delivery, small for GA (SGA) neonate (<10th percentile for GA), and NICU length of stay. Chi-square, ANOVA, and Student’s t test were performed for univariate analyses. Logistic regression modeling was performed to control for baseline differences. RESULTS: Eight hundred four twin pregnancies were identified; 48% of patients identified as non-Hispanic White, 30% as Hispanic, 10% as Asian/Pacific Islander, 5.6% as non-Hispanic Black, and 6.6% as other/mixed race. Age, parity, chorionicity, and body mass index differed between groups. The overall rate of NICU admission was 77.5% and did not differ by race and ethnicity ( P =.05). Pregnancies with at least one SGA neonate varied significantly by race and ethnicity ( P =.02). Gestational age at delivery, Apgar of less than 7, and ICU length of stay did not differ. CONCLUSION: The risk of having an SGA neonate varies by race and ethnicity in twin gestations, with highest rates among non-Hispanic Black women. Additional racial and ethnic disparities in neonatal morbidity were not found. Disparities in rate of preterm birth were not seen in this cohort.