PURPOSE: Our study aim was to identify factors that may contribute to the racial disparity in pregnancy-related mortality. METHODS: We examined differences in severity of disease, comorbidities, and receipt of care among 608 (304 African-American and 304 white) consecutive patients of non-Hispanic ethnicity with one of three pregnancy-related morbidities (pregnancy-related hypertension, puerperal infection, and hemorrhage) from hospitals selected at random from a statewide region. RESULTS: African-American women had more severe hypertension, lower hemoglobin concentrations preceding hemorrhage, more antepartum hospital admissions, and a higher rate of obesity. The rate of surgical intervention for hemorrhage was lower among African-Americans, although the severity of hemorrhage did not differ between the two racial groups. More African-American women received eclampsia prophylaxis. After stratifying by severity of hypertension, we found that more African-Americans received antihypertensive therapy. The rate of enrollment for prenatal care was lower in the African-American group. Among women receiving prenatal care, African-American women enrolled significantly later in their pregnancies. CONCLUSIONS: We have identified racial differences in severity of disease, comorbidities, and care status among women with pregnancy-related complications that would place African-Americans at disadvantage to survive pregnancy. These differences are potentially modifiable.
PURPOSE: Our study aim was to identify factors that may contribute to the racial disparity in pregnancy-related mortality. METHODS: We examined differences in severity of disease, comorbidities, and receipt of care among 608 (304 African-American and 304 white) consecutive patients of non-Hispanic ethnicity with one of three pregnancy-related morbidities (pregnancy-related hypertension, puerperal infection, and hemorrhage) from hospitals selected at random from a statewide region. RESULTS: African-American women had more severe hypertension, lower hemoglobin concentrations preceding hemorrhage, more antepartum hospital admissions, and a higher rate of obesity. The rate of surgical intervention for hemorrhage was lower among African-Americans, although the severity of hemorrhage did not differ between the two racial groups. More African-American women received eclampsia prophylaxis. After stratifying by severity of hypertension, we found that more African-Americans received antihypertensive therapy. The rate of enrollment for prenatal care was lower in the African-American group. Among women receiving prenatal care, African-American women enrolled significantly later in their pregnancies. CONCLUSIONS: We have identified racial differences in severity of disease, comorbidities, and care status among women with pregnancy-related complications that would place African-Americans at disadvantage to survive pregnancy. These differences are potentially modifiable.
Authors: Moshe Fridman; Lisa M Korst; Jessica Chow; Elizabeth Lawton; Connie Mitchell; Kimberly D Gregory Journal: Am J Public Health Date: 2013-12-19 Impact factor: 9.308
Authors: F Carol Bruce; Cynthia J Berg; Peter J Joski; Douglas W Roblin; William M Callaghan; Joanna E Bulkley; Donald J Bachman; Mark C Hornbrook Journal: Paediatr Perinat Epidemiol Date: 2012-08-29 Impact factor: 3.980
Authors: Elena V Kuklina; Susan F Meikle; Denise J Jamieson; Maura K Whiteman; Wanda D Barfield; Susan D Hillis; Samuel F Posner Journal: Obstet Gynecol Date: 2009-02 Impact factor: 7.661
Authors: James Nodler; Surjit R Moolamalla; Elizabeth M Ledger; Bahij S Nuwayhid; Zuber D Mulla Journal: BMC Pregnancy Childbirth Date: 2009-03-16 Impact factor: 3.007