Racial Disparities Among Preterm Births Rates in Preeclampsia [25B

Abstract

INTRODUCTION: Preeclampsia complicates 3-5% of deliveries in the United States and is a frequent cause of preterm birth. We sought to characterize the rates of preterm versus term deliveries stratified by race in preeclampsia both with (PE-SF) and without severe features (PE). METHODS: This is a retrospective cohort study of singleton, non-anomalous deliveries from 2005-2008 using linked vital statistics and ICD-9 data. Women self-reported into racial categories of white, black, Hispanic/Latina, Asian/Pacific Islander, or other. We used chi-squared tests to compare outcomes by preterm (<37 weeks gestation) or term (≥7 weeks gestation) and multiple logistic regression to adjust for age, race, education, insurance status, chronic hypertension, diabetes, gestational age at delivery, and birthweight. RESULTS: There were 58,878 births in our cohort complicated by preeclampsia with 16,073 births from PE-SF and 41,787 from PE. Within each racial category, the preterm versus term delivery rates were statistically significant with a p-value <0.001. Term deliveries were more common in both PE-SF and PE in all races except for Asian/Pacific Islanders which had 52.1% preterm births in PE-SF. The rate of preterm birth was higher in PE-SF compared to PE across all racial categories. Black women had the highest rate of preterm delivery for PE at 26% compared to white women who only had 17.8%. CONCLUSION: Rates of preterm deliveries were significantly higher for PE-SF compared to PE an racial disparities were most notable among Black women with PE. Further investigation should be directed at identifying why these disparities exist and how they can be addressed.