Race/Ethnic Differences on Postpartum Re-presentation [19C

Abstract

INTRODUCTION: Racial disparities may contribute to risk for postpartum readmission. We aim to identify racial/ethnic differences in indications for postpartum re-presentation. METHODS: This cohort study was conducted at a large urban US medical center. Demographic and obstetric data were collected on all patients who delivered within the study window (2012–2018) and re-presented for evaluation within 30 days of discharge from delivery admission. Indications for re-presentation were divided into the following categories; hypertension, infection (endometritis, urinary tract infection, wound infection), hemorrhage, and other (upper respiratory infection, edema, mastitis, etc). We evaluated the association between race and indication using chi square tests and performed logistic regression to account for potential confounding. RESULTS: A total of 1217 re-presented for evaluation within the study window. Black women were more likely to re-present for hypertension (P=.002). The adjusted odds ratio for black women re-presenting for hypertension versus white women was 2.09 (1.32, 3.33). In univariate analysis, black women were less likely to re-present for postpartum hemorrhage. However, this did not remain significant after adjusting for confounders. There were no statistically significant associations between race/ethnicity and the other indication groups. CONCLUSION: Black women are more likely to re-present for evaluation of hypertension within 30 days of delivery discharge. This association held true even after adjusting for age, BMI, delivery method, gestational age, multifetal gestation, and marital status. This group may most benefit from outpatient resources such as telemedicine and close follow up for blood pressure monitoring and medication adjustments.