702: Racial disparities in maternal outcomes among pregnant women with major depressive disorder

Abstract

We sought to determine the differences in maternal outcomes in pregnancies among white, black, Hispanic, Asian/Pacific Islander, and Native American women with major depressive disorder (MDD). A retrospective cohort of 18,453 women with MDD and singleton, non-anomalous gestations was used to examine maternal outcomes, assessed according to race. Maternal outcomes included pregnancy- associated hypertension (PAH), gestational diabetes (GDM), chorioamnionitis, blood transfusion, endometritis, and postpartum hemorrhage (PPH). Multivariate regression analyses and chi-square tests were employed for statistical comparisons and a p-value of less than 0.05 was used to indicate statistical significance. Overall, race was associated with a statistically significant increase in the majority of investigated outcomes. Compared to white women, and after controlling for confounders, black women with MDD were more likely to experience PAH (OR 1.52; 95%CI 1.24-1.86) and develop chorioamnionitis (OR 1.67; 95%CI 1.21-2.31). Hispanic women were more likely to develop GDM (OR 1.57; 95%CI 1.41-1.76), chorioamnionitis (OR 1.45; 95%CI 1.21-1.74), and endometritis (OR, 1.59; 95%CI, 1.12-2.27), and PPH (OR 1.34; 95%CI, 1.14-1.58). Asian/Pacific Islander women were more likely to develop GDM (OR 2.36; 95%CI 1.96-2.82), chorioamnionitis (OR 2.9; 95%CI 2.23-3.77), endometritis (OR 1.9; 95%CI 1.04-3.46), PPH (OR 1.70; 95%CI 1.29-2.24), and require blood transfusions (OR 2.46; 95%CI 1.51-3.99). Women of other races, including Native American, had higher rates chorioamnionitis (OR 2.77; 95%CI 1.24-6.20). Non-white women with MDD experience higher rates of obstetric complications than white women, with specific complications and rates varying across races. These data suggest disparities may exist in management of pregnant women with MDD across different races.