Observational studyAmerican journal of perinatology2023
Racial and Ethnic Disparities in Adverse Perinatal Outcomes at Term.
Observational study in American journal of perinatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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The trial behind it
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Who cites it
6 citing papers in PubMed.
- A group prenatal care intervention reduces gestational weight gain and gestational diabetes in American Samoan women.Obesity (Silver Spring, Md.) · 2024Trial
- Timing of initiation of therapeutic hypothermia in neonates with hypoxic ischemic encephalopathy born at a high-volume urban safety net hospital.Early human development · 2025Article
- The Relationship Between Hispanic Ethnicity and Outcomes for Infants Born Extremely Preterm.The Journal of pediatrics · 2025Article
- Health Insurance and Differences in Infant Mortality Rates in the US.JAMA network open · 2023Article
- Early-Life Outcomes in Relation to Social Determinants of Health for Children Born Extremely Preterm.The Journal of pediatrics · 2023Article
- The PERI Model of Radical Healing as a Framework for Advancing Perinatal Mental Health.Health equityArticle
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
objectiveThis study aimed to evaluate whether racial and ethnic disparities in adverse perinatal outcomes exist at term. STUDY
designWe performed a secondary analysis of a multicenter observational study of 115,502 pregnant patients and their neonates (2008-2011). Singleton, nonanomalous pregnancies delivered from 37 to 41 weeks were included. Race and ethnicity were abstracted from the medical record and categorized as non-Hispanic White (White; referent), non-Hispanic Black (Black), non-Hispanic Asian (Asian), or Hispanic. The primary outcome was an adverse perinatal composite defined as perinatal death, Apgar score < 4 at 5 minutes, ventilator support, hypoxic-ischemic encephalopathy, subgaleal hemorrhage, skeletal fracture, infant stay greater than maternal stay (by ≥ 3 days), brachial plexus palsy, or facial nerve palsy.
resultsOf the 72,117 patients included, 48% were White, 20% Black, 5% Asian, and 26% Hispanic. The unadjusted risk of the primary outcome was highest for neonates of Black patients (3.1%, unadjusted relative risk [uRR] = 1.16, 95% confidence interval [CI]: 1.04-1.30), lowest for neonates of Hispanic patients (2.1%, uRR = 0.80, 95% CI: 0.71-0.89), and no different for neonates of Asian (2.6%), compared with those of White patients (2.7%). In the adjusted model including age, body mass index (BMI), smoking, obstetric history, and high-risk pregnancy, differences in risk for the primary outcome were no longer observed for neonates of Black (adjusted relative risk [aRR] = 1.06, 95% CI: 0.94-1.19) and Hispanic (aRR = 0.92, 95% CI: 0.81-1.04) patients. Adding insurance to the model lowered the risk for both groups (aRR = 0.85, 95% CI: 0.75-0.96 for Black; aRR = 0.68, 95% CI: 0.59-0.78 for Hispanic).
conclusionAlthough neonates of Black patients have the highest frequency of adverse perinatal outcomes at term, after adjustment for sociodemographic factors, this higher risk is no longer observed, suggesting the importance of developing strategies that address social determinants of health to lessen extant health disparities. KEY POINTS: · Term neonates of Black patients have the highest crude frequency of adverse perinatal outcomes.. · After adjustment for confounders, higher risk for neonates of Black patients is no longer observed.. · Disparities in outcomes are strongly related to insurance status..
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