The Relationship of Patient/Provider Racial Concordance to Nulliparous, Term, Singleton, Vertex Cesarean Delivery Rates [ID 2683595

Abstract

INTRODUCTION: Prior studies have explored factors affecting nulliparous, term, singleton, vertex cesarean (NTSV-C) delivery rates, such as induction, provider type, and racial disparities. Some studies have shown higher NTSV-C rates among non-White patients compared to their White counterparts. Our aim was to study the influence of racial concordance between patient and provider on NTSV outcomes. METHODS: A retrospective analysis of 315 NTSV pregnancies at an urban hospital from January to March 2023 was performed. The NTSV outcomes by racial concordance were examined using χ2 and Fisher exact tests with alpha <.05. Logistic regression analysis was used to adjust for high-risk maternal comorbidities. The race of patients and delivering providers was based on self-identification. RESULTS: A majority of patient–provider dyads were concordant for race (199/315 [63.2%]). Racial concordance was associated with a lower NTSV-C rates (23.1 versus 33.6%; P=.04). This association persisted after adjusting for maternal comorbidities (P=.003). When NTSV outcomes were stratified by patient race, significant differences in cesarean delivery rates by patient race were observed for White providers (P=.02). No significant differences between races were observed for Asian (P=.93) or Black providers (P=.82). CONCLUSION: These results emphasize the significant effect of racial concordance between patients and providers on cesarean delivery rates, highlighting the need for further examination of health care disparities and tailored interventions to promote equitable maternal care.