The association between maternal race and adverse outcomes in twin pregnancies with similar healthcare access
| Autor: | Marti D. Soffer, Nathan S. Fox, Julie Romero, Aren Gottlieb, Stephanie Melka, Mariam Naqvi |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty Pediatrics Adverse outcomes Twins Mothers Logistic regression Health Services Accessibility White People Preeclampsia 03 medical and health sciences Young Adult 0302 clinical medicine Pregnancy Health care medicine Humans 030212 general & internal medicine Twin Pregnancy Minority Groups Retrospective Studies Univariate analysis 030219 obstetrics & reproductive medicine Obstetrics business.industry Racial Groups Infant Newborn Pregnancy Outcome Obstetrics and Gynecology Retrospective cohort study medicine.disease Gestational diabetes Pediatrics Perinatology and Child Health Pregnancy Twin Female business |
| Zdroj: | The journal of maternal-fetalneonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. 31(18) |
| ISSN: | 1476-4954 |
| Popis: | To compare twin pregnancy outcomes between white and nonwhite women with similar access to health care.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.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 birth32 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).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. |
| Databáze: | OpenAIRE |
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