Persistent Racial/Ethnic Disparities in Supine Sleep Positioning among U.S.-born Preterm Infants, 2000-2015.

OBJECTIVE To assess trends in racial disparity in supine sleep positioning across racial/ethnic groups of early preterm (EPT;<34 weeks) and late preterm (LPT;34-36 weeks) infants from 2000-2015. STUDY DESIGN We analyzed Pregnancy Risk Assessment Monitoring System (PRAMS) data (a population-based perinatal surveillance system) from 16 U.S. states from 2000 to 2015 (Weighted N=1,020,986). Marginal prevalence of SSP by year was estimated for EPT and LPT infants, adjusting for maternal and infant characteristics. After stratifying EPT and LPT infants, adjusted odds of SSP trends were compared across racial/ethnic groups by testing the time-race interaction. RESULTS From 2000 to 2015, Non-Hispanic Black infants had lower odds of SSP compared with Non-Hispanic White infants for EPT (AOR:0.61;95% CI 0.47-0.78) and LPT (AOR:0.44;95% CI:0.34-0.56) groups. For Hispanic infants, there was no statistically significant difference for either preterm group when compared with Non-Hispanic White infants. Adjusted odds of supine sleep positioning increased (on average) annually by 10.0%,7.3% and 7.7% respectively in Non-Hispanic White, Non-Hispanic Black, and Hispanic EPT infants and by 5.8%,5.9%, and 4.8% among Non-Hispanic White, Non-Hispanic Black, and Hispanic LPT infants. However, there were no significant between-group differences in annual changes (EPT:p=0.11; LPT:p=0.25). CONCLUSIONS Supine sleep positioning increased for all racial/ethnic preterm groups from 2000 to 2015. However, the racial/ethnic disparity in supine sleep positioning among EPT and LPT groups persists.