Racial and Ethnic Inequities in Postpartum Pain Evaluation and Management
Racial and Ethnic Inequities in Postpartum Pain Evaluation and Management
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DOI：
10.1097/aog.0000000000003505
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发表时间：
2019-12-01
影响因子：
7.2
通讯作者：
Stuebe, Alison M.
中科院分区：
文献类型：
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作者：
Johnson, Jasmine D.;Asiodu, Ifeyinwa V.;Stuebe, Alison M.
目的：为了评估疼痛评估和治疗的频率是否因患者种族和种族而异，我们对2014年7月1日至2016年6月30日期间在一家机构接受剖宫产手术并导致活产新生儿的所有女性进行了回顾性队列研究。记录的疼痛评分和分娩后给予的药物分为产后0-24小时和25-48小时。计算记录的疼痛评分数量，无论任何疼痛评分是否为7/10或更高，以及给予的镇痛药物。调整模型的倾向分数，包括产妇年龄，体重指数，胎龄，初产，初次与重复剖宫产，经典的子宫切开术，并入院新生儿重症监护室。结果：共1,987名妇女被确定，1,701符合纳入标准。记录了30，984次疼痛评分。重度疼痛（7/10或更高）在黑人（28%）和西班牙裔（22%）女性中比白色（20%）或亚洲（15%）女性更常见。在剖腹产后的前24小时内，非西班牙裔白色妇女的疼痛评估记录（校正均值10.2）多于黑人、亚洲人和西班牙裔妇女（校正均值8.4-9.5; P
OBJECTIVE: To evaluate whether the frequency of pain assessment and treatment differed by patient race and ethnicity for women after cesarean birth.METHODS: We performed a retrospective cohort study of all women who underwent cesarean birth resulting in a liveborn neonate at a single institution between July 1, 2014, and June 30, 2016. Pain scores documented and medications administered after delivery were grouped into 0-24 and 25-48 hours postpartum time periods. Number of pain scores recorded, whether any pain score was 7 of 10 or greater, and analgesic medication administered were calculated. Models were adjusted for propensity scores incorporating maternal age, body mass index, gestational age, nulliparity, primary compared with repeat cesarean delivery, classical hysterotomy, and admission to the neonatal intensive care unit.RESULTS: A total of 1,987 women were identified, and 1,701 met inclusion criteria. There were 30,984 pain scores documented. Severe pain (7/10 or greater) was more common among black (28%) and Hispanic (22%) women than among women who identified as white (20%) or Asian (15%). In the first 24 hours after cesarean birth, non-Hispanic white women had more documented pain assessments (adjusted mean 10.2) than, black, Asian, and Hispanic women (adjusted mean 8.4-9.5; P