Person:

Seiglie, Jacqueline

Objective: To determine whether the prevalence of neonatal hypoglycemia differs by race/ethnicity. Study Design A retrospective cohort study using prospectively collected data from 515 neonates born very preterm (<32 weeks) to normoglycemic women and admitted to the neonatal intensive care unit (NICU) at a major tertiary hospital in Boston, MA between 2008 and 2012. Results: A total of 61%, 12%, 7%, 7%, and 13% were White, Black, Hispanic, Asian, and Other, respectively. Among the 66% spontaneous preterm births, 63% of the black neonates experienced hypoglycemia (blood glucose level<40 mg/dL), while only 22–30% of the other racial/ethnic neonates did so (Black v. White RR 2.15; 95% CI: 1.54–3.00). After adjusting for maternal education, maternal age, multiple gestations, delivery type, gestational age, birth weight and neonates’ sex, this association remained significant (adjusted Black v. White RR: 1.61, 95% CI: 1.13–2.29). An increased risk of infant hypoglycemia was not seen in infants of other racial/ethnic groups, nor in any racial/ethnic group with a medically-indicated preterm birth. Conclusions: Black neonates delivered for spontaneous (but not medical) indications at <32 weeks had a higher risk of hypoglycemia, which could provide critical information about mechanisms of preterm birth and adverse postnatal outcomes in this high-risk group.

Evidence on cardiovascular disease (CVD) risk factor prevalence among adults living below the World Bank’s international line for extreme poverty globally is sparse, as prior studies have used setting-specific rather than absolute measures of poverty. Here, we e pooled individual-level data from 105 nationally representative household surveys across 78 countries, representing 85% of people living in extreme poverty globally, and sorted individuals by country-specific measures of household income or wealth to identify those in extreme poverty. CVD risk factors (hypertension, diabetes, smoking, obesity, and dyslipidemia) were present among a substantial proportion of adults in extreme poverty, and most were not treated for CVD-related conditions (e.g., among those with hypertension earning <$1.90/day, 15.2% (95% CI: 13.3% – 17.1%) reported taking BP-lowering medication). The main limitation of our analysis is its potential measurement error-related misestimation of CVD risk factor . Nonetheless, our results could inform equity discussions for resource allocation and design of effective interventions.