Racial and Ethnic Disparities in Maternal Outcomes and the Disadvantage of Peripartum Black Women: A Multistate Analysis, 2007-2014

被引:64
作者
Tangel, Virginia [1 ]
White, Robert S. [2 ]
Nachamie, Anna S. [1 ]
Pick, Jeremy S. [2 ]
机构
[1] Weill Cornell Med, Dept Anesthesiol, Ctr Perioperat Outcomes, New York, NY USA
[2] Weill Cornell Med, NewYork Presbyterian Hosp, Dept Anesthesiol, 525 East 68th St, New York, NY 10065 USA
关键词
racial; ethnic disparities; in-hospital maternal mortality; cesarean delivery; administrative database; outcomes research; maternal length of stay; PREGNANCY-RELATED MORTALITY; CESAREAN DELIVERY RATES; AFRICAN-AMERICAN WOMEN; BODY-MASS INDEX; LENGTH-OF-STAY; UNITED-STATES; SOCIOECONOMIC DISPARITIES; STRUCTURAL RACISM; HEALTH; RISK;
D O I
10.1055/s-0038-1675207
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective Racial and ethnic disparities in obstetric care and delivery outcomes have shown that black women experience high rates of pregnancy-related mortality and morbidity, along with high rates of cesarean delivery, compared with other racial and ethnic groups. We aimed to quantify these disparities and test the effects of race/ethnicity in stratified statistical models by insurance payer and socioeconomic status, adjusting for comorbidities specific to an obstetric population. Study Design We analyzed maternal outcomes in a sample of 6,872,588 delivery records from California, Florida, Kentucky, Maryland, and New York from 2007 to 2014 from the State Inpatient Databases, Healthcare Cost and Utilization Project. We compared present-on-admission characteristics of parturients by race/ethnicity, and estimated logistic regression and generalized linear models to assess outcomes of in-hospital mortality, cesarean delivery, and length of stay. Results Compared with white women, black women were more likely to die in-hospital (odds ratio [OR]: 1.90, 95% confidence interval [CI]: 1.47-2.45) and have a longer average length of stay (incidence rate ratio: 1.10, 95% CI: 1.09-1.10). Black women also were more likely to have a cesarean delivery (OR: 1.12, 95% CI 1.12-1.13) than white women. These results largely held in stratified analyses. Conclusion In most insurance payers and socioeconomic strata, race/ethnicity alone is a factor that predicts parturient outcomes.
引用
收藏
页码:835 / 848
页数:14
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