Disparities in Maternal Outcomes Among Four Ethnic Populations

Authors

Jay J. Shen, University of Nevada, Las VegasFollow
Catherine Tymkow, Governors State University, FlossmoorFollow
Nancy J. MacMullen, Governors State University, Oak ForestFollow

Document Type

Article

Publication Date

Summer 2005

Publication Title

Ethnicity & Disease

Volume

15

Issue

3

First page number:

492

Last page number:

497

Abstract

OBJECTIVE: To examine racial disparities in adverse maternal outcomes among four ethnic groups in the United States.

DESIGN, SETTING, AND PARTICIPANTS: A total of 1,030,350 women aged 13 to 55 who delivered in 1998 and 1999. Data were abstracted from the National Inpatient Sample.

MAIN OUTCOME MEASURES:

Race was categorized as White, African-American, Hispanic, and Asian/Pacific Islander. Maternal outcome measures included preterm labor, hypertensive disorders of pregnancy, gestational diabetes, antepartum hemorrhage, membrane disorders, cesarean section, and postpartum hemorrhage.

RESULTS: African Americans were more likely to have preterm labor (odds ratio [OR] 1.71), preeclampsia (OR 1.59), transient hypertension of pregnancy (THP) (OR 1.13), pregnancy-induced hypertension (PIH) (OR 1.38), diabetes (OR 1.26), placenta previa (OR 1.78), placental abruption (OR 1.52), premature rupture of membranes (PRM) (OR 1.19), infection of the amniotic cavity (IAC) (OR 1.95), and cesarean section (risk ratio [RR] 1.08); Hispanics were more likely to have diabetes (OR 1.44), placenta previa (OR 1.20), IAC (OR 1.15), and cesarean section (RR 1.06); and Asian/Pacific Islanders were more likely to have diabetes (OR 2.05), placenta previa (OR 1.57), PRM (OR 1.26), IAC (1.79), and postpartum hemorrhage (OR 1.19).

CONCLUSIONS: African Americans had the worst outcomes when adjusted for sociodemographic characteristics and comorbidities. Infection, gestational diabetes, and control of hypertension, especially among African Americans, are the most significant preventable risk factors contributing to disparities. By increasing access to health services, health education, and appropriate perinatal care in minority populations, improvements are likely to occur across multiple measures including frequencies of preterm labor, cesarean section, and gestational diabetes.

Keywords

Health services accessibility; Minorities – Medical care; Outcome assessment (Medical care); Pregnancy – Complications; Pregnant women; Race

Disciplines

Maternal and Child Health | Obstetrics and Gynecology | Race and Ethnicity | Women's Health

Language

English

Permissions

Use Find in Your Library, contact the author, or interlibrary loan to garner a copy of the item. Publisher policy does not allow archiving the final published version. If a post-print (author's peer-reviewed manuscript) is allowed and available, or publisher policy changes, the item will be deposited.

Repository Citation

Shen, J. J., Tymkow, C., MacMullen, N. J. (2005). Disparities in Maternal Outcomes Among Four Ethnic Populations. Ethnicity & Disease, 15(3), 492-497.