Why African-American women are at greater risk for pregnancy-related death
Meyers Primary Care Institute; Department of Medicine, Division of Geriatric Medicine
Adult; African Americans; Comorbidity; Female; Health Behavior; *Health Status; Humans; *Maternal Mortality; Pregnancy; Pregnancy Complications; Prenatal Care
Health Services Research | Primary Care
PURPOSE: Our study aim was to identify factors that may contribute to the racial disparity in pregnancy-related mortality.
METHODS: We examined differences in severity of disease, comorbidities, and receipt of care among 608 (304 African-American and 304 white) consecutive patients of non-Hispanic ethnicity with one of three pregnancy-related morbidities (pregnancy-related hypertension, puerperal infection, and hemorrhage) from hospitals selected at random from a statewide region.
RESULTS: African-American women had more severe hypertension, lower hemoglobin concentrations preceding hemorrhage, more antepartum hospital admissions, and a higher rate of obesity. The rate of surgical intervention for hemorrhage was lower among African-Americans, although the severity of hemorrhage did not differ between the two racial groups. More African-American women received eclampsia prophylaxis. After stratifying by severity of hypertension, we found that more African-Americans received antihypertensive therapy. The rate of enrollment for prenatal care was lower in the African-American group. Among women receiving prenatal care, African-American women enrolled significantly later in their pregnancies.
CONCLUSIONS: We have identified racial differences in severity of disease, comorbidities, and care status among women with pregnancy-related complications that would place African-Americans at disadvantage to survive pregnancy. These differences are potentially modifiable.
DOI of Published Version
Ann Epidemiol. 2007 Mar;17(3):180-5. Link to article on publisher's site
Annals of epidemiology
Harper, Margaret A.; Dugan, Elizabeth; Espeland, Mark A.; Martinez-Borges, Anibal; and Mcquellon, Cynthia, "Why African-American women are at greater risk for pregnancy-related death" (2007). Meyers Primary Care Institute Publications and Presentations. 402.