Maternal Race and Clinical Vigilance in Obstetric Hemorrhage Management [A147

Abstract

INTRODUCTION: Non-White maternal race has been associated with an increased risk for severe morbidity from obstetric hemorrhage (OBH). In the present study, we investigate the hypothesis that such disparities could be secondary to delay in the administration of standard third stage oxytocin or decreased use of additional hemorrhage interventions for pregnant patients of color compared to White patients. METHODS: We performed a retrospective cohort of all deliveries from 2018 to 2019 at our institution. The two groups compared were 1) Hispanic White or non-White race (HW/NWR) pregnant people and 2) non-Hispanic White (NHW) pregnant people. The primary outcome was time from delivery to first dose of postpartum oxytocin; secondary outcome was the frequency of additional hemorrhage interventions. Groups were compared using t test and chi-square or Fisher’s exact tests. RESULTS: Of 3,832 patients who delivered a live infant between January 1, 2018, and December 31, 2019, with self-identified race and ethnicity recorded in their patient record, 644 patients identified as NHW and 3,188 patients identified as HW/NWR. There was no difference in time to first dose of postpartum oxytocin (P=.51). There was also no difference in frequency of administration of any individual uterotonics, tranexamic acid, transfusion, uterine artery embolization, or hemorrhage-related surgical techniques. CONCLUSION: There was no delay in the administration of postpartum oxytocin when comparing non-White and Hispanic White patients to non-Hispanic White patients. Additional research is needed to continue to explore systemic causes of and solutions for racial disparities in obstetric hemorrhage.