Risk Factors and Racial Disparities of Maternal and Neonatal Morbidity at Premier Health Maternity Facilities [ID 2683422

Abstract

INTRODUCTION: Nationally, racial disparities in obstetrical outcomes have proven to be contributing to the high maternal morbidity and mortality rates in the United States when compared to other developed nations. To best approach the inequalities in our community, we sought to determine whether and where obstetrical outcomes were being disproportionately affected by the race of the patient. METHODS: We conducted a retrospective chart review of patients delivering singleton pregnancies at 37 weeks of gestation or greater from January 2019 to July 2021. Using the patient’s self-identified race, regression modeling was used to identify disparities in obstetrical outcomes. A composite of maternal outcomes consisting of third/fourth-degree lacerations, blood transfusion, febrile morbidity, and ICU admission was used to compare morbidities. Neonatal composite morbidity consisted of respiratory distress, sepsis, need for resuscitation, and neonatal intensive care unit (NICU) admission. This study was approved by the Wright State University IRB (protocol number: 07272). RESULTS: There were 13,689 births during the study period. Significantly more non-Caucasian patients experienced cesarean sections than Caucasian patients (30.3% versus 28.5%; P <.01) and on average had a higher maternal composite score (0.5 versus 0.03; P <.01). Black or African American babies were more likely to qualify as small for gestational age, be admitted to the NICU, and have a higher composite score than Caucasian babies (P<.01). CONCLUSION: Within our community, obstetrical and neonatal outcomes were experienced at significantly different rates by different race groups. Next steps include creating standardized protocols to decrease the opportunity for implicit bias to adversely affect patient care.