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Abstract
BackgroundRacial disparities in adverse perinatal outcomes have been studied in other countries, but little has been done for the Canadian population. In this study, we sought to examine the disparities in adverse perinatal outcomes between Asians and Caucasians in Ontario, Canada.MethodsWe conducted a population-based retrospective cohort study that included all Asian and Caucasian women who attended a prenatal screening and resulted in a singleton birth in an Ontario hospital (April 1st, 2015-March 31st, 2017). Generalized estimating equation models were used to estimate the independent adjusted relative risks and adjusted risk difference of adverse perinatal outcomes for Asians compared with Caucasians.ResultsAmong 237,293 eligible women, 31% were Asian and 69% were Caucasian. Asians were at an increased risk of gestational diabetes mellitus, placental previa, early preterm birth (< 32 weeks), preterm birth, emergency cesarean section, 3rd and 4th degree perineal tears, low birth weight (< 2500 g, < 1500 g), small-for-gestational-age (<10th percentile, <3rd percentile), neonatal intensive care unit admission, and hyperbilirubinemia requiring treatment, but had lower risks of preeclampsia, macrosomia (birth weight > 4000 g), large-for-gestational-age neonates, 5-min Apgar score < 7, and arterial cord pH ≤7.1, as compared with Caucasians. No difference in risk of elective cesarean section was observed between Asians and Caucasians.ConclusionThere are significant differences in several adverse perinatal outcomes between Asians and Caucasians. These differences should be taken into consideration for clinical practices due to the large Asian population in Canada.
Highlights
Racial disparities in adverse perinatal outcomes have been studied in other countries, but little has been done for the Canadian population
Women who were diagnosed with diabetes prior to the index pregnancy were excluded for analysis of gestational diabetes mellitus (GDM)
Asian women were less likely to be nulliparous, be overweight/obese, partake in alcohol consumption/substance use/smoking during pregnancy, have pre-existing disease, have mental health problems, and less likely to deliver in alower maternal level of care hospital (Table 1)
Summary
Racial disparities in adverse perinatal outcomes have been studied in other countries, but little has been done for the Canadian population. We sought to examine the disparities in adverse perinatal outcomes between Asians and Caucasians in Ontario, Canada. Racial disparities in health outcomes have been widely recognized [1]. Racial disparities in perinatal outcomes have been believed due to the complexities of social, genetic and environmental factors [1, 5, 6]. Racial disparities in access to health care and prenatal care as well as insurance coverage are demonstrated to contribute to differential health outcomes [7,8,9,10]. A previous study noted that women belonging to a racial/
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