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Racial/Ethnic Disparities in Maternal Morbidities: A Statewide Study of Labor and Delivery Hospitalizations in Wisconsin

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Abstract

We examined racial/ethnic disparities in maternal morbidities (MM) and the number of MM during labor and delivery among hospital discharges in Wisconsin. We conducted a retrospective cohort study of hospital discharge data for 206,428 pregnant women aged 13–53 years using 2005–2007 Healthcare Cost and Utilization Project State Inpatient Dataset (HCUP-SID) for Wisconsin. After adjustments for covariates, MM (preterm labor, antepartum and postpartum hemorrhage, hypertension in pregnancy, gestational diabetes, membrane-related disorders, infections and 3rd and 4th perineal lacerations) were examined using logistic regression models, and number of MM (0, 1, 2, >2 MM) were examined using multivariable ordered logistic regressions with partial proportional odds models. African–Americans had significantly higher likelihood of infections (OR = 1.74; 95% CI 1.60–1.89), preterm labor (OR = 1.42; 1.33–1.50), antepartum hemorrhage (OR = 1.63; 1.44–1.83), and hypertension complicating pregnancy (OR = 1.39; 1.31–1.48) compared to Whites. Hispanics, Asian/Pacific Islanders, and Native Americans had significantly higher likelihood of infections, postpartum hemorrhage, and gestational diabetes than Whites. Major perineal lacerations were significantly higher among Asian/Pacific Islanders (OR = 1.53; 1.34–1.75). All minority racial/ethnic groups, except Asians, had significantly higher likelihood of having 0 versus 1, 2 or >2 MM, 0 or 1 versus 2 or >2 MM, and 0, 1 or 2 versus >2 MM than white women. Findings show significant racial/ethnic disparities in MM, and suggest the need for better screening, management, and timely referral of these conditions, particularly among racial/ethnic women. Disparities in MM may be contributing to the high infant mortality and adverse birth outcomes among different racial/ethnic groups in Wisconsin.

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Authors and Affiliations

  1. Department of Pediatrics, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI, 53226, USA

    Erwin T. Cabacungan

  2. Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, 53201, USA

    Emmanuel M. Ngui

  3. Center for Patient Care and Outcomes Research, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI, 53226, USA

    Emily L. McGinley

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  1. Erwin T. Cabacungan
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  2. Emmanuel M. Ngui
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  3. Emily L. McGinley
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Correspondence to Erwin T. Cabacungan.

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Cabacungan, E.T., Ngui, E.M. & McGinley, E.L. Racial/Ethnic Disparities in Maternal Morbidities: A Statewide Study of Labor and Delivery Hospitalizations in Wisconsin. Matern Child Health J 16, 1455–1467 (2012). https://doi.org/10.1007/s10995-011-0914-6

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  • DOI: https://doi.org/10.1007/s10995-011-0914-6

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