Abstract
Non-Hispanic Black (NHB) pregnant women experience higher rates of maternal morbidity compared to their non-Hispanic White (NHW) peers, regardless of influenza. Whether NHB experience worse outcomes with influenza remains to be defined. Our objective was to assess whether NHB women with influenza during pregnancy are at increased risk of severe maternal morbidity (SMM). An analysis of delivery hospitalizations with influenza during pregnancy was conducted using the 2000-2015 National Inpatient Sample. Maternal race was assessed for women of NHW, NHB, and Hispanic race. Outcomes were SMM excluding transfusion (defined by the Centers for Disease Control and Prevention), and complications of influenza, sepsis/shock, acute respiratory distress syndrome (ARDS), and mechanical ventilation/tracheostomy. Trend analysis was conducted presenting the average annual percent change (AAPC). The association between maternal race and outcomes were calculated using log linear models, adjusted for demographic, hospital, and clinical variables. Between 2000-2015, 182,228 (0.3%) deliveries were complicated by influenza and 15.7% of women were NHB. Overall, 2.1% had SMM, 4.8% sepsis/shock, 23.4% ARDS, and 4.2% mechanical ventilation/tracheostomy. The rate of SMM was higher among NHB compared to NHW patients with an AAPC 5.6% (95% CI: 0.7%, 10.7%) versus 5.1% (95% CI: 1.2%, 9.3%) (Figure). NHB women with influenza were at higher risk of SMM compared to their NHW peers (3.5% vs. 2.0%, aRR 1.64, 95% CI: 1.48, 1.81) and similarly elevated with mechanical ventilation and sepsis/shock (Table). Non-Hispanic Black women with influenza during pregnancy experience higher rates of maternal morbidity compared to their non-Hispanic White peers. Addressing racial disparities in adverse outcomes for pregnant women with influenza should be a public health priority, including improving influenza vaccination rates in minority populations.View Large Image Figure ViewerDownload Hi-res image Download (PPT)
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