302 Maternal race/ethnicity impacts the success rates of external cephalic version in the US

Abstract

We aimed to assess whether a racial/ethnic disparity exists with respect to the success rates of external cephalic version (ECV) for breech presentation. This is a retrospective analysis of the Centers for Disease Control & Prevention’s Natality Live Birth database (2016-2018). We compared the success rates of ECV across US pregnant women within different racial/ethnic groups (non-Hispanic Whites, non-Hispanic Blacks, non-Hispanic Asians and Hispanics) using the Pearson chi-square test. Inclusion criteria included singleton, term births with a birth weight of 2500 to 5000 grams. The odds for ECV success for the different racial/ethnic groups were calculated via multivariate logistic regression controlling for maternal parity, pre-pregnancy BMI, weight gain during pregnancy, as well as for neonatal birth weight. Results were displayed as adjusted Odds Ratios with 95% confidence intervals, and statistical significance was determined as a p-value below 0.05 Of the 11,150,527 live births in 2016 to 2018, 26,255 women in the examined racial/ethnic groups underwent an ECV and met the inclusion criteria. The overall ECV success rate was 52.75% (13,850 women). Non-Hispanic Blacks had the highest success rate (64.52%), followed by Hispanics (59.21%) and non-Hispanic Asians (55.51%) [Figure 1]. These rates were significantly higher than those of non-Hispanic Whites (p<0.001). The differences between the racial/ethnic groups remain similar after controlling for maternal pre-pregnancy BMI, maternal gain weight during pregnancy, parity and neonatal birth weight in a logistic regression. Non-Hispanic blacks were associated with the highest success rate (adjusted OR 1.95, 95% CI 1.77-2.15) [Table 1]. There are significant differences in the success rates of ECV among different maternal racial/ethnic groups. Non-Hispanic White women have the lowest ECV success rate, while non-Hispanic Black women have the highest ECV success rate. Further investigation may discover the underlying causes for this disparity.View Large Image Figure ViewerDownload Hi-res image Download (PPT)