902 Racial and ethnic disparities in neonatal outcomes of mothers with chronic hypertension

Abstract

To compare outcomes of neonates born to mothers with chronic hypertension based on maternal race and ethnicity. A retrospective cohort study from the Consortium on Safe Labor of unique persons with chronic hypertension and available self-reported maternal race and ethnicity (2002-2008). Maternal race and ethnicity were analyzed as non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic. The following neonatal outcomes were compared between the three groups: preterm birth, low birth weight, small for gestational age (SGA), 5-minute Apgar <7, respiratory distress syndrome, hypoxic-ischemic encephalopathy (HIE), intraventricular hemorrhage, admission to neonatal intensive care unit (NICU), neonatal sepsis, and neonatal death were compared between persons with singleton gestations. Univariable and multivariable analyses were performed to examine the association between maternal race and ethnicity and neonatal outcomes in mothers with chronic hypertension, while controlling for maternal sociodemographic and clinical factors. A total of 4,612 persons were eligible for analysis. Most of maternal sociodemographic and clinical characteristics differed between the groups (Table 1). All neonatal outcomes except HIE differed between the three groups with all of the rates being significantly higher in NHB mothers compared with NHW mothers (Table 1). The outcomes of low birth weight, neonatal sepsis, and neonatal death were also higher in Hispanic compared to NHW group. In multivariable logistic regression, neonates of NHB mothers had higher odds of preterm birth, SGA, low birth weight, 5-min Apgar<7, NICU admission and neonatal sepsis compared with NHW mothers (Table 2). Similarly, neonates of Hispanic mothers had higher odds of preterm birth, low birth weight, NICU admission, neonatal sepsis and also neonatal death compared with NHW mothers. Significant racial disparities were seen in neonatal outcomes of mothers with chronic hypertension, with neonates born to NHB and Hispanic mothers having higher rates of complications.View Large Image Figure ViewerDownload Hi-res image Download (PPT)