Racial Disparities in Severe Maternal Morbidities Across the Pregnancy Continuum in the United States [17A]. (May 2018)

• Record Type: Journal Article
• Authors: Liese, Kylea L.; Mogos, Mulubrhan; Abboud, Sarah; DeCocker, Karen; Geller, Stacie
• Is Part Of: Obstetrics and gynecology. Volume 131(2018)Supplement 1
• Publication Date: 2018-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000532880.26778.81
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: This study investigates racial disparities in severe maternal morbidities (SMM) among antepartum (AP), intrapartum (IP) and postpartum (PP) U.S. hospital admissions between 2002 and 2014. METHODS: AP, IP and PP hospitalizations were identified in the National Inpatient Sample (NIS) from the Healthcare Cost and Utilization Project for 2002-2014. ICD-9 codes indicating severe complications were used to identify hospitalizations with SMM. Individual-level co-morbidities, sociodemographic and behavioral characteristics were extracted from the NIS databases. The distribution of sociodemographic, behavioral, hospital characteristics, insurance, and comorbidities by whether a SMM occurred was summarized using descriptive statistics across the pregnancy continuum. Joinpoint regression was used to examine temporal trends of SMM during the study period by timing of hospitalization and stratified by race. Multivariate logistic regression was used to assess the association between race and SMM. RESULTS: Compared to Non-Hispanic White women, Black women hospitalized during the AP period are 70% more likely to experience SMM after adjusting for demographic, behavioral, hospital characteristics, insurance, and comorbidities (aOR = 1.7, 95% CI: [1.6-1.8]). The increased risk among Black women persisted during IP (aOR= 1.4, 95% CI: [1.3-1.5] and PP hospitalizations (aOR = 1.2, 95% CI: [1.1-1.2]. Hispanic women demonstrated comparable SMM risk during AP and slightly higher SMM risk during IP (aOR- 1.2 (1.1-1.3) to Non-Hispanic Whites. Interestingly, they had 20% less risk of SMM during PP hospitalization when compared to Non-Hispanic White women. CONCLUSION: Race significantly impacts both the timing and type of SMM a woman may experience, implicating further research on mechanisms and interventions to address disparities.