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The association between maternal race and adverse outcomes in twin pregnancies with similar healthcare access

The journal of maternal-fetal & neonatal medicine, 2018-09, Vol.31 (18), p.2424-2428 [Peer Reviewed Journal]

2017 Informa UK Limited, trading as Taylor & Francis Group 2017 ;ISSN: 1476-7058 ;EISSN: 1476-4954 ;DOI: 10.1080/14767058.2017.1344634 ;PMID: 28629273

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Title:
The association between maternal race and adverse outcomes in twin pregnancies with similar healthcare access
Author: Soffer, Marti D. ; Naqvi, Mariam ; Melka, Stephanie ; Gottlieb, Aren ; Romero, Julie ; Fox, Nathan S.
Subjects: Adult ; Continental Population Groups - ethnology ; Continental Population Groups - statistics & numerical data ; Disparities ; European Continental Ancestry Group - statistics & numerical data ; Female ; Health Services Accessibility - standards ; Health Services Accessibility - statistics & numerical data ; Humans ; Infant, Newborn ; maternal race ; Minority Groups - statistics & numerical data ; Mothers - statistics & numerical data ; outcomes ; Pregnancy ; Pregnancy Outcome - epidemiology ; Pregnancy Outcome - ethnology ; Pregnancy, Twin - ethnology ; Pregnancy, Twin - statistics & numerical data ; Retrospective Studies ; Twins ; Young Adult
Is Part Of: The journal of maternal-fetal & neonatal medicine, 2018-09, Vol.31 (18), p.2424-2428
Description: Objective: To compare twin pregnancy outcomes between white and nonwhite women with similar access to health care. Methods: Retrospective cohort study of all twin pregnancies delivered by a single maternal-fetal medicine practice from 2005-2016. All patients had private health insurance and equal access to physician care. Outcomes were compared between white and nonwhite women using logistic regression to adjust for differences at baseline. Results: Of the 858 women included, 730 (85.1%) were white and 128 (14.9%) were nonwhite. Univariate analysis demonstrated that nonwhite women had higher rates of preterm birth <32 weeks (12.5 versus 6.7%, p = .022), cesarean delivery (78.1% versus 61.4% of all women, p < .001 and 43.5% versus 16.1% of women who attempted labor, p < .001), preeclampsia (22.4% versus 14.5%, p = .029) and gestational diabetes (23.2% versus 7.3%, p < .001). On adjusted analysis, nonwhite race remained significantly associated with cesarean delivery in women who attempted labor (aOR 2.27, 95% CI: 1.09, 4.71) and gestational diabetes (aOR 2.61, 95% CI: 1.53, 4.45). Conclusions: Nonwhite women with twin pregnancies have an increased risk of adverse outcomes that cannot be explained by access to care. Although improving access to care is an important goal for health care systems, our data suggest that this alone will not eliminate all disparities in health care outcomes between women of different races.
Publisher: England: Taylor & Francis
Language: English
Identifier: ISSN: 1476-7058
EISSN: 1476-4954
DOI: 10.1080/14767058.2017.1344634
PMID: 28629273
Source: MEDLINE

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The association between maternal race and adverse outcomes in twin pregnancies with similar healthcare access

2017 Informa UK Limited, trading as Taylor & Francis Group 2017 ;ISSN: 1476-7058 ;EISSN: 1476-4954 ;DOI: 10.1080/14767058.2017.1344634 ;PMID: 28629273

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