Racial and ethnic disparities in severe maternal morbidity prevalence and trends
Racial and ethnic disparities in severe maternal morbidity prevalence and trends
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DOI：
10.1016/j.annepidem.2019.02.007
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发表时间：
2019-05-01
影响因子：
5.6
通讯作者：
Carmichael, Suzan L.
中科院分区：
文献类型：
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作者：
Leonard, Stephanie A.;Main, Elliott K.;Carmichael, Suzan L.
目的：严重孕产妇发病率 (SMM) 的种族/族裔差异很大，但很少有人知道这些差异是否会随着时间的推移而变化，或者孕产妇和产科因素的作用。方法：我们使用 1997 年至 2014 年期间加利福尼亚州出生的相关出生证明和分娩记录（n = 8,252,025）检查了 SMM 患病率和趋势的差异。结果：SMM 患病率最高的是非西班牙裔 (NH) 黑人女性 (1.63%)，新罕布什尔州白人女性最低 (0.84%)，并且从 1997 年到 2014 年，每个种族/族裔群体都增加了约 170%。随着时间的推移，SMM 差异的大小保持一致。与新罕布什尔州白人女性相比，西班牙裔女性（RR 1.14；95% CI 1.12, 1.16）、亚裔/太平洋岛民女性（RR 1.23；95% CI 1.20, 1.26）、新罕布什尔州黑人女性（RR 1.27；95% CI 1.23, 131）和美洲印第安人/阿拉斯加原住民女性的 SMM 调整风险较高（RR 1.29；95% Cl 1.15、1.44），考虑了合并症、贫血、剖腹产和其他产妇特征。结论：SMM 的患病率因种族/民族的不同而有很大差异，但在所有种族/民族群体中以同样高的比率增加。合并症、剖腹产和其他因素并不能完全解释 SMM 的差异，这种差异随着时间的推移仍然持续存在。 (C) 2019 Elsevier Inc. 保留所有权利。
Purpose: Racial/ethnic disparities in severe maternal morbidity (SMM) are substantial, but little is known about whether these disparities are changing over time or the role of maternal and obstetric factors.Methods: We examined disparities in SMM prevalence and trends using linked birth certificate and delivery discharge records from Californian births during 1997-2014 (n = 8,252,025).Results: The prevalence of SMM was highest in non-Hispanic (NH) Black women (1.63%), lowest in NH White women (0.84%), and increased from 1997 to 2014 by approximately 170% in each racial/ethnic group. The magnitude of SMM disparities remained consistent over time. Compared with NH White women, the adjusted risk of SMM was higher in women who identified as Hispanic (RR 1.14; 95% CI 1.12, 1.16), Asian/Pacific Islander (RR 1.23; 95% CI 1.20, 1.26), NH Black (RR 1.27; 95% CI 1.23, 131), and American Indian/Alaska Native (RR 1.29; 95% Cl 1.15, 1.44), accounting for comorbidities, anemia, cesarean birth, and other maternal characteristics.Conclusions: The prevalence of SMM varied considerably by race/ethnicity but increased at similarly high rates among all racial/ethnic groups. Comorbidities, cesarean birth, and other factors did not fully explain the disparities in SMM, which remained persistent over time. (C) 2019 Elsevier Inc. All rights reserved.