ArticleAmerican journal of preventive medicine2026
Severe Maternal Morbidity at the Intersection of Race and Disability: Evidence of Compounded Disparities in the U.S. Maternal Healthcare System.
Article in American journal of preventive medicine, 2026. 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.
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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.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Doula Support During Pregnancy, Childbirth, and Postpartum: A Systematic Review and Meta-Analysis.Obstetrics and gynecology · 2026Pooled it
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Authors and funding
5 authors.
Funding
Abstract
introductionThe aim of this study was to examine severe maternal morbidity at the intersection of race and physical disability status using nationally representative data.
methodsThis study conducted a pooled cross-sectional analysis of delivery hospitalizations in 2025 using 2004-2022 Healthcare Cost and Utilization Project Nationwide Inpatient Sample data. Delivery hospitalizations and physical disabilities were identified using validated International Classification of Diseases, Ninth/ICD-10 Revisions-based algorithms. The primary outcome was severe maternal morbidity excluding blood transfusion-only cases. Secondary outcomes included severe maternal morbidity severity measured by the number of severe maternal morbidity indicators (≥2 or ≥3) and specific severe maternal morbidity categories. Risk ratios were calculated using modified Poisson regression and evaluated additive interaction using the Relative Excess Risk due to Interaction and Attributable Proportion.
resultsAmong 8,584,800 delivery hospitalizations, 88,389 (1.0%) were to women with physical disabilities. Black disabled women with 528 per 10,000 deliveries (528.0; 95% CI=492.8, 565.5) had the highest rates of severe maternal morbidity, followed by White women with physical disabilities (213.9; 95% CI=203.6, 224.7) and Black women without physical disabilities (107.7; 95% CI=105.3, 110.1). White women without physical disabilities with 61 per 10,000 deliveries (60.7; 95% CI=59.4, 62.1) had the lowest rate of severe maternal morbidity. After adjustment, Black women with physical disabilities had 6.92 times the risk of severe maternal morbidity (95% CI=6.45, 7.44) compared with White women without disabilities. The adjusted Relative Excess Risk due to Interaction for severe maternal morbidity was 2.07 (95% CI=1.67, 2.47), and the Attributable Proportion due to interaction was 0.38 (95% CI=0.33, 0.43), suggesting that 38% of excess risk among Black women with physical disabilities was attributable to the interaction between race and physical disability.
conclusionsBlack women with physical disabilities experience compounded risks of severe maternal morbidity that exceed the sum of risks associated with race or physical disability alone. These findings underscore the need for intersectional approach to develop effective interventions to improve maternal care quality and outcomes in this high-risk population.
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