000			04322nam a22005897a 4500
008			160113s20152015 xxu||||| |||| 00| 0 eng d
022			_a0029-7844
040			_aOvid MEDLINE(R)
099			_a26000518
245			_aRacial and ethnic disparities in maternal morbidity and obstetric care.
251			_aObstetrics & Gynecology. 125(6):1460-7, 2015 Jun.
252			_aObstet Gynecol. 125(6):1460-7, 2015 Jun.
253			_aObstetrics and gynecology
260			_c2015
260			_fFY2015
266			_d2016-01-13
501			_aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
520			_aCONCLUSION: Racial and ethnic disparities exist for multiple adverse obstetric outcomes and types of obstetric care and do not appear to be explained by differences in patient characteristics or by delivery hospital.
520			_aLEVEL OF EVIDENCE: II.
520			_aMETHODS: We analyzed data from a cohort of women who delivered at 25 hospitals across the United States over a 3-year period. Race and ethnicity was categorized as non-Hispanic white, non-Hispanic black, Hispanic, or Asian. Associations between race and ethnicity and severe postpartum hemorrhage, peripartum infection, and severe perineal laceration at spontaneous vaginal delivery as well as between race and ethnicity and obstetric care (eg, episiotomy) relevant to the adverse outcomes were estimated by univariable analysis and multivariable logistic regression.
520			_aOBJECTIVE: To evaluate whether racial and ethnic disparities exist in obstetric care and adverse outcomes.
520			_aRESULTS: Of 115,502 studied women, 95% were classified by one of the race and ethnicity categories. Non-Hispanic white women were significantly less likely to experience severe postpartum hemorrhage (1.6% non-Hispanic white compared with 3.0% non-Hispanic black compared with 3.1% Hispanic compared with 2.2% Asian) and peripartum infection (4.1% non-Hispanic white compared with 4.9% non-Hispanic black compared with 6.4% Hispanic compared with 6.2% Asian) than others (P<.001 for both). Severe perineal laceration at spontaneous vaginal delivery was significantly more likely in Asian women (2.5% non-Hispanic white compared with 1.2% non-Hispanic black compared with 1.5% Hispanic compared with 5.5% Asian; P<.001). These disparities persisted in multivariable analysis. Many types of obstetric care examined also were significantly different according to race and ethnicity in both univariable and multivariable analysis. There were no significant interactions between race and ethnicity and hospital of delivery.
546			_aEnglish
650			_a*Health Status Disparities
650			_a*Healthcare Disparities/eh [Ethnology]
650			_a*Lacerations/eh [Ethnology]
650			_a*Perineum/in [Injuries]
650			_a*Postpartum Hemorrhage/eh [Ethnology]
650			_a*Pregnancy Complications, Infectious/eh [Ethnology]
650			_aAdult
650			_aAfrican Americans/sn [Statistics & Numerical Data]
650			_aAsian Americans/sn [Statistics & Numerical Data]
650			_aDelivery, Obstetric/ae [Adverse Effects]
650			_aEpisiotomy/sn [Statistics & Numerical Data]
650			_aEuropean Continental Ancestry Group/sn [Statistics & Numerical Data]
650			_aFemale
650			_aHispanic Americans/sn [Statistics & Numerical Data]
650			_aHumans
650			_aLacerations/et [Etiology]
650			_aPeripartum Period
650			_aPregnancy
650			_aUnited States/ep [Epidemiology]
650			_aYoung Adult
651			_aMedStar Washington Hospital Center
656			_aObstetrics and Gynecology, Maternal-Fetal Medicine
657			_aJournal Article
657			_aResearch Support, N.I.H., Extramural
700			_aReddy, Uma M
790			_aBailit JL, Blackwell SC, Caritis SN, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network, Grobman WA, Iams JD, Leveno KJ, Reddy UM, Rice MM, Rouse DJ, Saade G, Thorp JM Jr, Tita AT, Tolosa JE, VanDorsten JP, Varner MW, Wapner RJ
856			_uhttp://dx.doi.org/10.1097/AOG.0000000000000735 _zhttp://dx.doi.org/10.1097/AOG.0000000000000735
942			_cART _dArticle
999			_c1225 _d1225