890 Obstetric outcomes and costs associated with eclampsia by race and ethnicity

Abstract

We sought to determine whether the hospitalization costs and outcomes differ among women with eclampsia and their infants by race and ethnicity. This was a retrospective cohort study of women delivering in California between 2007-2011 with the diagnosis of eclampsia. This study included women with singleton, non-anomalous live births between 23-42 weeks’ gestation. We excluded women with chronic hypertension or pre-existing diabetes mellitus, missing data, length of stay, race/ethnicity, or gestational age. We examined costs (2020 USD), length of stay, and gestational age at delivery for women and infants. We also looked at rates of cesarean delivery, severe maternal mortality (SMM), NICU admission and hypoxic-ischemic encephalopathy. Hospitalization costs were reported separately for women and infants. Analyses were conducted using Kruskal-Wallis test of significance, one-way analysis of variance, or chi-squared with an alpha of 0.05. In this study, 2,655 women-infant dyads met inclusion criteria. Of these, 642 (24%) were White, 241 (9%) were Black, 1,476 (56%) were Hispanic, 210 (8%) were Asian, and 68 (3%) were Native American. The rates of cesarean delivery were significantly different between groups. Hispanic women with eclampsia had the highest rates of cesarean delivery (61.6%). The rates of SMM were also significantly different between groups and was highest among Hispanic women (31.5%). Neonatal outcomes did not vary significantly. Asian women had the highest median hospitalization costs ($28,728), while White women had the lowest ($20,864). Infants born to Asian women had the highest costs ($5,227) and those born to Native American women had the lowest ($3,504). Among women with SMM, Asian women and their infants had the highest costs. Native American mothers and infants born to Native American women had the highest cost when infants were admitted to the NICU. Among women with eclampsia, maternal outcomes, costs, and infants' costs, were significantly different based on race and ethnicity. Future research should investigate these disparities.View Large Image Figure ViewerDownload Hi-res image Download (PPT)