Racial and Ethnic Disparities in the Incidence of Severe Maternal Morbidity in the United States, 2012-2015
Racial and Ethnic Disparities in the Incidence of Severe Maternal Morbidity in the United States, 2012-2015
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DOI：
10.1097/aog.0000000000002937
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发表时间：
2018-11-01
影响因子：
7.2
通讯作者：
Dalton, Vanessa K.
中科院分区：
文献类型：
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作者：
Admon, Lindsay K.;Winkelman, Tyler N. A.;Dalton, Vanessa K.
目的：描述美国分娩住院期间严重孕产妇发病率的种族和民族差异。方法：我们对2012-2015年全国住院患者样本的数据进行汇总、横断面分析，以确定非西班牙裔白人、非西班牙裔黑人、西班牙裔、亚洲或太平洋岛民、美洲原住民或阿拉斯加原住民妇女分娩中慢性疾病的患病率和严重孕产妇发病率。我们使用加权多变量逻辑回归和预测边际来产生患病率和发病率估计。计算调整后的比率和差异，以量化种族和族裔类别之间的差异。进行亚组分析，以检查在每个种族和族裔类别中，患有共病身体健康状况、行为健康状况和多种慢性病的妇女分娩时严重产妇发病率。结果：与非西班牙裔白人妇女分娩相比，每个种族和少数民族妇女分娩时严重产妇发病率显著高于非西班牙裔白人妇女。在非西班牙裔黑人和非西班牙裔白人妇女中，每10,000名分娩住院患者中，严重的孕产妇发病率分别为231.1 （95% CI 223.6-238.5）和139.2 （95% CI 136.4-142.0）
OBJECTIVE: To describe racial and ethnic disparities in the incidence of severe maternal morbidity during delivery hospitalizations in the United States.METHODS: We conducted a pooled, cross-sectional analysis of 2012-2015 data from the National Inpatient Sample to define the prevalence of chronic conditions and incidence of severe maternal morbidity among deliveries to non-Hispanic white, non-Hispanic black, Hispanic, Asian or Pacific Islander, and Native American or Alaska Native women. We used weighted multivariable logistic regression and predictive margins to generate prevalence and incidence estimates. Adjusted rate ratios and differences were calculated to quantify disparities across racial and ethnic categories. Subgroup analyses were performed to examine the incidence of severe maternal morbidity among deliveries to women with comorbid physical health conditions, behavioral health conditions, and multiple chronic conditions within each racial and ethnic category.RESULTS: The incidence of severe maternal morbidity was significantly higher among deliveries to women in every racial and ethnic minority category compared with deliveries among non-Hispanic white women. Severe maternal morbidity occurred in 231.1 (95% CI 223.6-238.5) and 139.2 (95% CI 136.4-142.0) per 10,000 delivery hospitalizations among non-Hispanic black and non-Hispanic white women, respectively (P