179 Effects of institutional racism on social determinants of heath and increased rates of mortality and morbidity amongst premature infants born to Black mothers

OBJECTIVES/GOALS: Premature birth and its complications are among the largest contributions to infant death within the US. The rates of premature birth and infant death are significantly higher among African Americans. Therefore, there is an urgent need to understand the biological and social drivers of this health disparities to improve birth outcomes. METHODS/STUDY POPULATION: This is a retrospective cohort study of premature infants (< 28 weeks estimated gestational age, birth weight < 1500g) born within 2018 and 2021 to mothers who identify as either African American, or White/Caucasian Non-Hispanic and are cared for at Saint Louis Children’s Hospital Neonatal Intensive Care Unit. EPIC collected data will include maternal and fetal factors and social determinants of health (SDOH). ICD-9, ICD-10 codes for primary outcomes include grade 3-4 Interventricular Hemorrhage, moderate-severe Bronchopulmonary Dysplasia, Stage 2+ Necrotizing Enterocolitis, and moderate-severe Retinopathy of Prematurity. Will develop a composite variable score using the SDOH for risk/no risk using that for each disease outcome and mortality. Will use Chi-square test or T-test to compare groups. RESULTS/ANTICIPATED RESULTS: We are currently in the data collection phase of the study, but we anticipate seeing an increase in risk of all-cause morbidity as well as all-cause mortality for infants born to Black mothers compared to infants born to White mothers. We anticipate higher levels of disadvantage (increased area deprivation scores) and lower access to the goods and services deemed necessary for appropriate care of Black mothers and subsequent relation to outcomes for their infants. DISCUSSION/SIGNIFICANCE: Following analysis and assessment of that analysis we will discuss these findings and the impact on the general population and the needs for improvement and implementation of interventions upstream in the care of the vulnerable and special mother-baby-dyad population.