The association of maternal race and ethnicity and the risk of postpartum hemorrhage.

Abstract:

BACKGROUND:There are profound racial and ethnic disparities in obstetric outcomes in the United States, but little is known about disparities in risk of postpartum hemorrhage (PPH). We explored the association of race and ethnicity on the risk of PPH due to uterine atony with sequential adjustment for possible mediating factors. METHODS:This analysis was based on the Nationwide Inpatient Sample, from between 2005 and 2008. The frequencies of atonic PPH and atonic PPH resulting in transfusion or hysterectomy were estimated. We developed multivariable logistic regression models to estimate the odds of these outcomes in maternal racial/ethnic groups by sequentially adding potential mediators. RESULTS:Hispanic ethnicity and Asian/Pacific Islander race were associated with a statistically significant increased odds of atonic PPH in comparison with Caucasians, despite adjustment for potential mediators (adjusted odds ratio [OR] for Hispanics: 1.21, 99% confidence interval [1.18, 1.25]; for Asians/Pacific Islanders: 1.31 [1.25, 1.38], with Caucasians as reference). Similar results were observed for these racial/ethnic groups for atonic PPH resulting in transfusion or hysterectomy. CONCLUSION:Hispanic ethnicity and Asian/Pacific Islander race are significant risk factors for atonic PPH independent of measured potential mediators; biological differences may play a role.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Bryant A,Mhyre JM,Leffert LR,Hoban RA,Yakoob MY,Bateman BT

doi

10.1213/ANE.0b013e3182691e62

subject

Has Abstract

pub_date

2012-11-01 00:00:00

pages

1127-36

issue

5

eissn

0003-2999

issn

1526-7598

pii

ANE.0b013e3182691e62

journal_volume

115

pub_type

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