1040 Doula support impact on maternal health outcomes for minority women: a meta-analysis of observational studies

Abstract

Despite the available literature on the overarching positive impact of birth doulas on maternal health outcomes, little information pertains to their impact specifically on minority laboring populations. Thus, we aimed to assess the effect of doula care on maternal health outcomes in minority women populations. A systematic review of peer-reviewed, English language, observational studies was conducted using PubMed, CINAHL, Web of Science, PsycInfo, and SCOPUS databases. Observational trials that met our inclusion criteria were compiled, and studies were assessed for primary outcomes such as length of labor, cesarean section rate, epidural use, and breastfeeding initiation. Secondary outcomes included APGAR Score (>7), low birth weight, obstetric intervention, and preterm birth rate. All articles were assessed for risk of bias by two authors and a third author was consulted for any discrepancies. RevMan 5.3 was used to analyze the data. Odds ratios were estimated using random effect or fixed effects if applicable. Heterogeneity between studies was assessed using I2 > 50%. Our initial search resulted in 1074 articles, of which 8 observational studies (n= 799,775) were included for meta-analysis. Results showed that those who received doula care were 49% less likely to have a low birth weight baby as compared to those who did not receive doula care (OR=0.51, 95%CI= 0.36-0.71). Women who received doula care were also 22% less likely to deliver by cesarean section than those who did not receive doula care (OR=0.78, 95%CI= 0.59-1.02). Interestingly, breastfeeding initiation rates were much lower (OR=10.25, 95%CI= 1.82-57.72) amongst those who received doula care. No statistical differences were found in epidural use (OR=1.23, 95%CI= 0.94-1.63), preterm birth (OR=0.91, 95%CI= 0.57-1.44), APGAR Score (OR= 1.46, 95%CI= 0.97-2.20), or obstetric interventions (OR=0.76, 95%CI= 0.39-1.47). Our meta-analysis aligns with the available literature on the positive impact of doula support on cesarean delivery and low birthweight rates.View Large Image Figure ViewerDownload Hi-res image Download (PPT)