Evidence map›Paper›PMID 37205300›Full record

ArticleAJOG global reports2023

Increased maternal morbidity and mortality among Asian American and Pacific Islander women in the military health system.

Patrizia C Grob, Rachel R Tindal, Kathleen R Lundeberg, Jameaka L Hamilton, Veronica M Gonzalez-Brown, Erin A Keyser

Open access · goldAbstract read
In one paragraph

Article in AJOG global reports, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 1 country.

Patrizia C GrobRocky Vista University College of Osteopathic Medicine, Parker, CO (Dr Grob).
Rachel R TindalUniversity of Alabama Heersink School of Medicine, Birmingham, AL (Dr Tindal).
Kathleen R LundebergCollege of Osteopathic Medicine, Pacific Northwest University of Health Sciences, Yakima, WA (Dr Lundeberg).
Jameaka L HamiltonDepartment of Gynecologic Surgery & Obstetrics, Mike O'Callaghan Military Medical Center, Nellis Air Force Base, Las Vegas, NV (Dr Hamilton).
Veronica M Gonzalez-BrownDepartment of Gynecologic Surgery & Obstetrics, San Antonio Uniformed Services Health Education Consortium, Brooke Army Medical Center, Fort Sam Houston, TX (Drs Gonzalez-Brown and Keyser).
Erin A KeyserDepartment of Gynecologic Surgery & Obstetrics, San Antonio Uniformed Services Health Education Consortium, Brooke Army Medical Center, Fort Sam Houston, TX (Drs Gonzalez-Brown and Keyser).
Brooke Army Medical Center · USMike O'Callaghan Federal Medical Center · USPacific Northwest University of Health Sciences · USRocky Vista University · USUniversity of Alabama · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRates of maternal morbidity and mortality experienced by women in the United States have been shown to vary significantly by race, most commonly attributed to differences in access to healthcare and socioeconomic status. Recent data showed that Asian Pacific Islanders have the highest rate of maternal morbidity despite having a higher socioeconomic status. In the military, women of all races are granted equal access to healthcare, irrespective of socioeconomic class. We hypothesized that within the military, there would be no racial disparities in maternal outcomes because of universal healthcare.

objectiveThis study aimed to evaluate if universal access to healthcare, as seen in the military healthcare system, leads to similar rates of maternal morbidity regardless of racial or ethnic background. STUDY

designThis was a retrospective cohort study of data from the National Perinatal Information Center reports obtained from participating military treatment facilities from April 2019 to March 2020 and included 34,025 deliveries. We compared racial differences in the incidence of each of the following 3 outcomes: postpartum hemorrhage, severe maternal morbidity among women with postpartum hemorrhage including transfusion, and severe maternal morbidity among women with postpartum hemorrhage excluding transfusion.

resultsA total of 41 military treatment facilities (a list of participating military treatment facilities are provided in the Appendix) provided data that were included. There was an increased rate of postpartum hemorrhage (relative risk, 1.73; 95% confidence interval, 1.45-2.07), severe maternal morbidity including transfusion (relative risk, 1.22; 95% confidence interval, 0.93-1.61), and severe maternal morbidity excluding transfusion (relative risk, 1.97; 95% confidence interval, 1.02-3.8) among Asian Pacific Islander women when compared with Black or White women.

conclusionEven with equal access to healthcare in the military, Asian Pacific Islander women experience statistically significant increased rates of postpartum hemorrhage and severe maternal morbidity excluding transfusion when compared with Black or White women. The increased rates of severe maternal morbidity including transfusion were not statistically significant.

Indexed as

Asian Pacific Islandermaternal morbidity and mortalitymilitary health systempostpartum hemorrhageracial disparitiessevere maternal morbiditysocioeconomic status

Identifiers

PMID37205300
PMCPMC10185736
OpenAlexW4365505100

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.