Abstract
Discussion Forum (0)
Introduction: Racial disparities in obstetric outcome measures have been demonstrated in numerous studies. Disparities in process measures have yet to be subject to the same observation. This study aims to assess the magnitude of racial and ethnic disparities in perinatal process measures in a U.S. birth cohort.
Methods: A retrospective cohort study was conducted involving 58,280 singleton births (01/2017-3/2019) at 17 hospitals in the Northwest US. Process measures included antenatal steroids for births < 34 weeks, late-preterm steroid administration for late preterm (34+0-36+6 weeks) births, timely treatment of severe hypertension, episiotomy, and prophylactic antibiotics for 3rd/4th degree laceration. Unadjusted odds ratios and 95% CIs were calculated by race or ethnicity, using White as the reference group.
Results: Compared to White women, Hispanic women were less likely to receive late preterm steroids if they delivered at 34-36 weeks (OR 0.56; 95% CI 0.44-0.71) and antibiotics for a 3rd/4th degree laceration (OR 0.48; 95% CI 0.25-0.92). Hispanic and African-American women were more likely to receive timely treatment for severe hypertension (OR 1.64; 95% CI 1.24-2.19 and OR 1.51; 95% CI 1.01-2.26, respectively). Nulliparous vaginal births in Asian/Pacific Islander women were more likely to have an episiotomy (OR 1.51; 95% CI 1.27-1.81). Antenatal steroid administration for births < 34 weeks was similar across racial groups.
Conclusion/Implications: This study demonstrates that disparities exist in obstetric process measures. A better understanding of why these disparities exist and their relation to outcome disparities is needed.
Methods: A retrospective cohort study was conducted involving 58,280 singleton births (01/2017-3/2019) at 17 hospitals in the Northwest US. Process measures included antenatal steroids for births < 34 weeks, late-preterm steroid administration for late preterm (34+0-36+6 weeks) births, timely treatment of severe hypertension, episiotomy, and prophylactic antibiotics for 3rd/4th degree laceration. Unadjusted odds ratios and 95% CIs were calculated by race or ethnicity, using White as the reference group.
Results: Compared to White women, Hispanic women were less likely to receive late preterm steroids if they delivered at 34-36 weeks (OR 0.56; 95% CI 0.44-0.71) and antibiotics for a 3rd/4th degree laceration (OR 0.48; 95% CI 0.25-0.92). Hispanic and African-American women were more likely to receive timely treatment for severe hypertension (OR 1.64; 95% CI 1.24-2.19 and OR 1.51; 95% CI 1.01-2.26, respectively). Nulliparous vaginal births in Asian/Pacific Islander women were more likely to have an episiotomy (OR 1.51; 95% CI 1.27-1.81). Antenatal steroid administration for births < 34 weeks was similar across racial groups.
Conclusion/Implications: This study demonstrates that disparities exist in obstetric process measures. A better understanding of why these disparities exist and their relation to outcome disparities is needed.
Introduction: Racial disparities in obstetric outcome measures have been demonstrated in numerous studies. Disparities in process measures have yet to be subject to the same observation. This study aims to assess the magnitude of racial and ethnic disparities in perinatal process measures in a U.S. birth cohort.
Methods: A retrospective cohort study was conducted involving 58,280 singleton births (01/2017-3/2019) at 17 hospitals in the Northwest US. Process measures included antenatal steroids for births < 34 weeks, late-preterm steroid administration for late preterm (34+0-36+6 weeks) births, timely treatment of severe hypertension, episiotomy, and prophylactic antibiotics for 3rd/4th degree laceration. Unadjusted odds ratios and 95% CIs were calculated by race or ethnicity, using White as the reference group.
Results: Compared to White women, Hispanic women were less likely to receive late preterm steroids if they delivered at 34-36 weeks (OR 0.56; 95% CI 0.44-0.71) and antibiotics for a 3rd/4th degree laceration (OR 0.48; 95% CI 0.25-0.92). Hispanic and African-American women were more likely to receive timely treatment for severe hypertension (OR 1.64; 95% CI 1.24-2.19 and OR 1.51; 95% CI 1.01-2.26, respectively). Nulliparous vaginal births in Asian/Pacific Islander women were more likely to have an episiotomy (OR 1.51; 95% CI 1.27-1.81). Antenatal steroid administration for births < 34 weeks was similar across racial groups.
Conclusion/Implications: This study demonstrates that disparities exist in obstetric process measures. A better understanding of why these disparities exist and their relation to outcome disparities is needed.
Methods: A retrospective cohort study was conducted involving 58,280 singleton births (01/2017-3/2019) at 17 hospitals in the Northwest US. Process measures included antenatal steroids for births < 34 weeks, late-preterm steroid administration for late preterm (34+0-36+6 weeks) births, timely treatment of severe hypertension, episiotomy, and prophylactic antibiotics for 3rd/4th degree laceration. Unadjusted odds ratios and 95% CIs were calculated by race or ethnicity, using White as the reference group.
Results: Compared to White women, Hispanic women were less likely to receive late preterm steroids if they delivered at 34-36 weeks (OR 0.56; 95% CI 0.44-0.71) and antibiotics for a 3rd/4th degree laceration (OR 0.48; 95% CI 0.25-0.92). Hispanic and African-American women were more likely to receive timely treatment for severe hypertension (OR 1.64; 95% CI 1.24-2.19 and OR 1.51; 95% CI 1.01-2.26, respectively). Nulliparous vaginal births in Asian/Pacific Islander women were more likely to have an episiotomy (OR 1.51; 95% CI 1.27-1.81). Antenatal steroid administration for births < 34 weeks was similar across racial groups.
Conclusion/Implications: This study demonstrates that disparities exist in obstetric process measures. A better understanding of why these disparities exist and their relation to outcome disparities is needed.
Racial and Ethnic Disparities in Perinatal Process Measures
Erin Dwyer
Abstract
Discussion Forum (0)
Introduction: Racial disparities in obstetric outcome measures have been demonstrated in numerous studies. Disparities in process measures have yet to be subject to the same observation. This study aims to assess the magnitude of racial and ethnic disparities in perinatal process measures in a U.S. birth cohort.
Methods: A retrospective cohort study was conducted involving 58,280 singleton births (01/2017-3/2019) at 17 hospitals in the Northwest US. Process measures included antenatal steroids for births < 34 weeks, late-preterm steroid administration for late preterm (34+0-36+6 weeks) births, timely treatment of severe hypertension, episiotomy, and prophylactic antibiotics for 3rd/4th degree laceration. Unadjusted odds ratios and 95% CIs were calculated by race or ethnicity, using White as the reference group.
Results: Compared to White women, Hispanic women were less likely to receive late preterm steroids if they delivered at 34-36 weeks (OR 0.56; 95% CI 0.44-0.71) and antibiotics for a 3rd/4th degree laceration (OR 0.48; 95% CI 0.25-0.92). Hispanic and African-American women were more likely to receive timely treatment for severe hypertension (OR 1.64; 95% CI 1.24-2.19 and OR 1.51; 95% CI 1.01-2.26, respectively). Nulliparous vaginal births in Asian/Pacific Islander women were more likely to have an episiotomy (OR 1.51; 95% CI 1.27-1.81). Antenatal steroid administration for births < 34 weeks was similar across racial groups.
Conclusion/Implications: This study demonstrates that disparities exist in obstetric process measures. A better understanding of why these disparities exist and their relation to outcome disparities is needed.
Methods: A retrospective cohort study was conducted involving 58,280 singleton births (01/2017-3/2019) at 17 hospitals in the Northwest US. Process measures included antenatal steroids for births < 34 weeks, late-preterm steroid administration for late preterm (34+0-36+6 weeks) births, timely treatment of severe hypertension, episiotomy, and prophylactic antibiotics for 3rd/4th degree laceration. Unadjusted odds ratios and 95% CIs were calculated by race or ethnicity, using White as the reference group.
Results: Compared to White women, Hispanic women were less likely to receive late preterm steroids if they delivered at 34-36 weeks (OR 0.56; 95% CI 0.44-0.71) and antibiotics for a 3rd/4th degree laceration (OR 0.48; 95% CI 0.25-0.92). Hispanic and African-American women were more likely to receive timely treatment for severe hypertension (OR 1.64; 95% CI 1.24-2.19 and OR 1.51; 95% CI 1.01-2.26, respectively). Nulliparous vaginal births in Asian/Pacific Islander women were more likely to have an episiotomy (OR 1.51; 95% CI 1.27-1.81). Antenatal steroid administration for births < 34 weeks was similar across racial groups.
Conclusion/Implications: This study demonstrates that disparities exist in obstetric process measures. A better understanding of why these disparities exist and their relation to outcome disparities is needed.
Introduction: Racial disparities in obstetric outcome measures have been demonstrated in numerous studies. Disparities in process measures have yet to be subject to the same observation. This study aims to assess the magnitude of racial and ethnic disparities in perinatal process measures in a U.S. birth cohort.
Methods: A retrospective cohort study was conducted involving 58,280 singleton births (01/2017-3/2019) at 17 hospitals in the Northwest US. Process measures included antenatal steroids for births < 34 weeks, late-preterm steroid administration for late preterm (34+0-36+6 weeks) births, timely treatment of severe hypertension, episiotomy, and prophylactic antibiotics for 3rd/4th degree laceration. Unadjusted odds ratios and 95% CIs were calculated by race or ethnicity, using White as the reference group.
Results: Compared to White women, Hispanic women were less likely to receive late preterm steroids if they delivered at 34-36 weeks (OR 0.56; 95% CI 0.44-0.71) and antibiotics for a 3rd/4th degree laceration (OR 0.48; 95% CI 0.25-0.92). Hispanic and African-American women were more likely to receive timely treatment for severe hypertension (OR 1.64; 95% CI 1.24-2.19 and OR 1.51; 95% CI 1.01-2.26, respectively). Nulliparous vaginal births in Asian/Pacific Islander women were more likely to have an episiotomy (OR 1.51; 95% CI 1.27-1.81). Antenatal steroid administration for births < 34 weeks was similar across racial groups.
Conclusion/Implications: This study demonstrates that disparities exist in obstetric process measures. A better understanding of why these disparities exist and their relation to outcome disparities is needed.
Methods: A retrospective cohort study was conducted involving 58,280 singleton births (01/2017-3/2019) at 17 hospitals in the Northwest US. Process measures included antenatal steroids for births < 34 weeks, late-preterm steroid administration for late preterm (34+0-36+6 weeks) births, timely treatment of severe hypertension, episiotomy, and prophylactic antibiotics for 3rd/4th degree laceration. Unadjusted odds ratios and 95% CIs were calculated by race or ethnicity, using White as the reference group.
Results: Compared to White women, Hispanic women were less likely to receive late preterm steroids if they delivered at 34-36 weeks (OR 0.56; 95% CI 0.44-0.71) and antibiotics for a 3rd/4th degree laceration (OR 0.48; 95% CI 0.25-0.92). Hispanic and African-American women were more likely to receive timely treatment for severe hypertension (OR 1.64; 95% CI 1.24-2.19 and OR 1.51; 95% CI 1.01-2.26, respectively). Nulliparous vaginal births in Asian/Pacific Islander women were more likely to have an episiotomy (OR 1.51; 95% CI 1.27-1.81). Antenatal steroid administration for births < 34 weeks was similar across racial groups.
Conclusion/Implications: This study demonstrates that disparities exist in obstetric process measures. A better understanding of why these disparities exist and their relation to outcome disparities is needed.
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