Racial and Ethnic Disparities in Maternal and Neonatal Adverse Outcomes in College-Educated Women.

Abstract:

OBJECTIVE:To compare composite maternal and neonatal adverse outcomes among women with at least a bachelor's degree by racial and ethnic groups. METHODS:This was a retrospective cohort study using the U.S. vital statistics data sets. We included women with at least a bachelor's degree who delivered a nonanomalous live singleton neonate at 24-40 weeks. The primary outcome, composite maternal adverse outcome, included admission to intensive care unit, maternal transfusion, ruptured uterus, unplanned hysterectomy, or unplanned operating room procedure after delivery. The secondary outcome, composite neonatal adverse outcome, included 5-minute Apgar score less than 5, assisted ventilation for more than 6 hours, neonatal seizure, birth injury, or neonatal death. Multivariable regression models were used to estimate the association between maternal race and adverse outcomes. RESULTS:Of 11.8 million live births, 2.2 million (19%) met the inclusion criteria; 81.5% were to non-Hispanic white women, 8.5% to non-Hispanic black women, and 10% Hispanic women. The overall rate of composite maternal adverse outcome was 5.3 per 1,000 live births. Compared with non-Hispanic white women, the risk of the composite maternal adverse outcome was significantly higher among non-Hispanic black women (adjusted relative risk [aRR] 1.20; 95% CI 1.13-1.27), but lower among Hispanic women (aRR 0.69; 95% CI 0.64-0.74), a pattern which varied among different gestational age groups. The overall rate of composite neonatal adverse outcome was 11.6 per 1,000 live births. The risk of composite neonatal adverse outcome was significantly higher among neonates with non-Hispanic black mothers (aRR 1.25; 95% CI 1.20-1.30), but lower among neonates with Hispanic mothers (aRR 0.71; 95% CI 0.68-0.75), compared with neonates delivered by non-Hispanic white mothers and varied across gestational age. CONCLUSION:Among women with at least a bachelor's degree, small but measurable racial and ethnic disparities in composite maternal and neonatal adverse outcomes.

journal_name

Obstet Gynecol

authors

Tanner LD,Chen HY,Sibai BM,Chauhan SP

doi

10.1097/AOG.0000000000003887

subject

Has Abstract

pub_date

2020-07-01 00:00:00

pages

146-153

issue

1

eissn

0029-7844

issn

1873-233X

pii

00006250-202007000-00024

journal_volume

136

pub_type

杂志文章
  • Association Between First-Trimester Subchorionic Hematomas and Pregnancy Loss in Singleton Pregnancies.

    abstract:OBJECTIVE:To assess the association of a first-trimester subchorionic hematoma with pregnancy loss in women with singleton pregnancies. METHODS:We conducted a retrospective cohort study of all women with singleton pregnancies presenting for prenatal care before 14 weeks of gestation over a 3-year period at a single ob...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0000000000003360

    authors: Naert MN,Khadraoui H,Muniz Rodriguez A,Naqvi M,Fox NS

    更新日期:2019-08-01 00:00:00

  • Persistent right umbilical vein: sonographic detection and subsequent neonatal outcome.

    abstract:OBJECTIVE:To review our experience with antenatal detection and subsequent neonatal outcome of fetuses with a persistent right umbilical vein. METHODS:In a prospective observational study, 33 cases of persistent right umbilical vein were detected during 15,237 obstetric ultrasound examinations performed after 15 weeks...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Hill LM,Mills A,Peterson C,Boyles D

    更新日期:1994-12-01 00:00:00

  • Recurrent ovarian tumor with low malignant potential and cardiac metastasis.

    abstract:BACKGROUND:Up to 20% of ovarian epithelial tumors are classified as being of low malignant potential. Most of these low malignant potential tumors are detected at an early stage and have an excellent prognosis. This is a report of a woman with cardiac metastasis from an ovarian low malignant potential tumor. CASE:This...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(97)81429-9

    authors: Basil JB,Kost ER,Herzog TJ,Harris KM,Liapis H,Mutch DG

    更新日期:1997-05-01 00:00:00

  • ACOG Committee Opinion no. 598: Committee on Adolescent Health Care: The initial reproductive health visit.

    abstract::: The initial visit for screening and the provision of reproductive preventive health care services and guidance should take place between the ages of 13 years and 15 years. The initial reproductive health visit provides an excellent opportunity for the obstetrician-gynecologist to start a patient-physician relationsh...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/01.AOG.0000446826.46833.c0

    authors:

    更新日期:2014-05-01 00:00:00

  • Stage II carcinoma of the endometrium. An analysis of treatment.

    abstract::An analysis of 41 patients with histologically documented Stage II adenocarcinoma of the endometrium treated between 1969 and 1974 is presented. The 3-year survival for all patients was 46%. Patients treated with radiation therapy alone (tandem, ovoids, and external radiation therapy) had 29% survival while patients t...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Surwit EA,Fowler WC Jr,Rogoff EE

    更新日期:1978-07-01 00:00:00

  • Influence of an "opt-out" test strategy and patient factors on human immunodeficiency virus screening in pregnancy.

    abstract:OBJECTIVE:To estimate both human immunodeficiency virus (HIV) testing acceptance rates in pregnancy using an opt-out policy and patient characteristics influencing acceptance. METHODS:At the first prenatal visit, HIV testing was offered using an opt-out approach. Reasons for refusing testing were explored. Demographic...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/01.AOG.0000267497.39041.06

    authors: Yudin MH,Moravac C,Shah RR

    更新日期:2007-07-01 00:00:00

  • Mesonephroid carcinoma of the ovary. A clinicopathologic, histochemical, and electron microscopic study.

    abstract::Eighteen patients with mesonephroid ovarian carcinoma were investigated. Typical findings for the mesonephroid tumors were abundant extracellular an some intracellular neutral mucin mixed with sulfate and carboxyl groups, and large amounts of glycogen, especially in clear cells. The latter observation is considered to...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Klemi PJ,Grönroos M

    更新日期:1979-04-01 00:00:00

  • Human papillomavirus genotype prevalence in invasive vaginal cancer from a registry-based population.

    abstract:OBJECTIVE:To describe the human papillomavirus (HPV) genotype distribution in invasive vaginal cancers diagnosed before the introduction of the HPV vaccine and evaluate if survival differed by HPV status. METHODS:Four population-based registries and three residual tissue repositories provided formalin-fixed, paraffin-...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0000000000000171

    authors: Sinno AK,Saraiya M,Thompson TD,Hernandez BY,Goodman MT,Steinau M,Lynch CF,Cozen W,Saber MS,Peters ES,Wilkinson EJ,Copeland G,Hopenhayn C,Watson M,Lyu C,Unger ER

    更新日期:2014-04-01 00:00:00

  • What is new in intrauterine devices? Best articles from the past year.

    abstract::This month, we focus on current research about intrauterine devices. Dr. Hurd discusses four recent publications, and each is concluded with a "bottom line" that is the take-home message. The complete reference for each can be found in on this page, along with direct links to the abstracts. ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0b013e3182a6ad9f

    authors: Hurd WW

    更新日期:2013-10-01 00:00:00

  • Single-probe spectrophotometry in the assessment of fetal oxygenation.

    abstract::Six sheep fetuses were monitored with a single-probe tissue spectrophotometer. This spectrophotometer provides continuous digital output of the index of hemoglobin that is saturated with oxygen. To vary the fetal pO2, each maternal ewe was given room air, 100% oxygen, 12% oxygen, and 100% nitrogen via rebreathing bag....

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Egley CC,Seeds JW,Cefalo RC

    更新日期:1987-11-01 00:00:00

  • Comparison between urinary 17-ketosteroids and serum androgens in hirsute patients.

    abstract::In order to ascertain the usefulness of urinary 17-ketosteroids (17-KS) in the evaluation of hirsutism, 28 paired determinations of 17-KS and serum androgens were performed in 26 hirsute women before (control) and after (post Dex) 7 days of dexamethasone (Dex) administration. Upper normal control and post Dex urinary ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Maroulis GB,Manlimos FS,Abraham GE

    更新日期:1977-04-01 00:00:00

  • Recurrent obstetric management mistakes identified by simulation.

    abstract:OBJECTIVE:To develop a simulation-based curricular unit for labor and delivery teams involved in obstetric emergencies to detect and address common mistakes. METHODS:A simulation-based curricular unit for hands-on training of four obstetric emergency scenarios was developed using high-tech mannequins and low-tech simu...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/01.AOG.0000265208.16659.c9

    authors: Maslovitz S,Barkai G,Lessing JB,Ziv A,Many A

    更新日期:2007-06-01 00:00:00

  • Chronic pelvic pain and previous sexual abuse.

    abstract:OBJECTIVE:To determine whether there is an association between history of sexual abuse and development of chronic pelvic pain. METHODS:We studied 36 women with chronic pelvic pain, 23 with chronic low back pain, and 20 healthy women with reference to experience of sexual abuse, physical violence, and emotional neglect...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(00)01072-3

    authors: Lampe A,Sölder E,Ennemoser A,Schubert C,Rumpold G,Söllner W

    更新日期:2000-12-01 00:00:00

  • Tumor angiogenesis as a predictor of recurrence in stage Ib squamous cell carcinoma of the cervix.

    abstract:OBJECTIVE:To explore the possibility of using histologic microvessel count of sections from the tumor to predict recurrence of stage Ib squamous cell carcinoma of the cervix. METHODS:Tumor sections from 22 patients (11 patients free of disease after 3 years and 11 patients with recurrence) were stained histoimmunochem...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0029-7844(96)00039-7

    authors: Dinh TV,Hannigan EV,Smith ER,Hove MJ,Chopra V,To T

    更新日期:1996-05-01 00:00:00

  • Primary vulvar nocardiosis.

    abstract:BACKGROUND:Nocardiosis is an uncommon disease, and the primary skin infection is usually at the site of a recent injury. Nocardia is a saprophytic bacterium of the soil belonging to the order Actinomycetales. CASE:A 68-year-old woman presented with a painful, hard, dark reddish lesion located in the right hemivulva. S...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/01.AOG.0000188068.10174.90

    authors: Gallo A,Bettoni G,Trezzi G,Lalinga V,Frigerio L

    更新日期:2006-09-01 00:00:00

  • Management of interstitial ectopic pregnancies with a combined intra-amniotic and systemic approach.

    abstract:BACKGROUND:Approximately 2% of all pregnancies are ectopic; of these, 4% are interstitial or cervical. There exists no clear consensus as to whether surgical or medical management is superior. CASE:We present three cases of advanced nonfallopian tube ectopic pregnancies from 6 to 8 weeks of gestation. Our first two ca...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0b013e31828d58ee

    authors: Swank ML,Harken TR,Porto M

    更新日期:2013-08-01 00:00:00

  • Cervical ripening with combinations of vaginal prostaglandin F2-alpha estradiol, and relaxin.

    abstract::The first of a 2-part trial consisted of a double-blind randomized pilot study in which 4 groups of 10 patients near term received 1 of the following hormonal combinations in a vaginal gel 15 hours before surgical induction of labor: 1) prostaglandin F2 alpha (PGF2 alpha) and relaxin; 2) relaxin and estradiol; 3) estr...

    journal_title:Obstetrics and gynecology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: MacLennan AH,Green RC,Bryant-Greenwood GD,Greenwood FC,Seamark RF

    更新日期:1981-11-01 00:00:00

  • Clinical significance of urethral instability.

    abstract::Variations of urethral pressure were registered with microtransducers in 427 gynecologic patients with lower urinary tract symptoms during urethrocystometry. Urethral instability (variation of urethral pressure greater than 15 cm of water) was found in 16.4% of patients. The comparison of the urinary symptoms and the ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Weil A,Miège B,Rottenberg R,Krauer F

    更新日期:1986-07-01 00:00:00

  • Clinical applications of cell-free fetal DNA from maternal plasma.

    abstract:OBJECTIVE:To describe our clinical experience with detection and analysis of cell-free fetal DNA derived from maternal plasma for prenatal sexing and fetal rhesus-D typing. METHODS:Real-time quantitative polymerase chain reactions (PCRs) of rhesus-D sequences and the SRY gene were validated and offered to patients wit...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/01.AOG.0000103996.44503.F1

    authors: Rijnders RJ,Christiaens GC,Bossers B,van der Smagt JJ,van der Schoot CE,de Haas M

    更新日期:2004-01-01 00:00:00

  • Cervical intraepithelial neoplasia III: long-term outcome after cold-knife conization with clear margins.

    abstract:OBJECTIVE:To evaluate the long-term outcome of patients with severe cervical intraepithelial neoplasia or squamous cell carcinoma in situ (CIN III) after cold-knife conization with clear margins. METHODS:A total of 4417 women (mean age 36, range 18-72 years) with histologically confirmed CIN III had cold-knife conizat...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(00)01174-1

    authors: Reich O,Pickel H,Lahousen M,Tamussino K,Winter R

    更新日期:2001-03-01 00:00:00

  • Comparison of estrogen receptors in human premenopausal and postmenopausal uteri using isoelectric focusing.

    abstract::Previous studies have suggested that the estrogen receptor in the postmenopausal uterus, although capable of binding estrogen, may be inactive, that is, incapable of translocating and binding to nuclear acceptor sites. The present study uses isoelectric focusing to characterize differences in the estrogen receptor bet...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Pellikka PA,Sullivan WP,Coulam CB,Toft DO

    更新日期:1983-10-01 00:00:00

  • Paraganglioma complicating pregnancy and the puerperium.

    abstract::A rare case of a paraganglioma (extraadrenal pheochromocytoma) that complicated both pregnancy and the puerperium is described. The patient presented a confusing clinical picture simulating pregnancy-induced hypertension, which, after delivery, masqueraded as intractable fever of unknown origin. Computed tomography pr...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Kleiner GJ,Greston WM,Yang PT,Levy JL,Newman AD

    更新日期:1982-06-01 00:00:00

  • Umbilical cord blood interleukin-6 levels and neonatal morbidity.

    abstract:OBJECTIVE:To study umbilical cord interleukin-6 levels and the occurrence of neonatal sepsis, congenital pneumonia, necrotizing enterocolitis, and grade II-IV intraventricular hemorrhage. METHODS:Umbilical cord blood was collected from 133 preterm newborns. The study population was divided according to the presence or...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/S0029-7844(97)00421-3

    authors: Weeks JW,Reynolds L,Taylor D,Lewis J,Wan T,Gall SA

    更新日期:1997-11-01 00:00:00

  • Mixed gonadal dysgenesis without virilization.

    abstract::A 19-year-old phenotypic female with primary amenorrhea and 45X,0/46X,Y chromosomal mosaicism was found to have asymmetrical gonadal dysgenesis. Her lack of virilization precludes her precise categorization in the current nomenclature of gonadal dysgenesis and she is considered a unique variant of the syndrome of mixe...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Adashi E,Farber M,Safaii HS,Mitchell GW Jr

    更新日期:1977-10-01 00:00:00

  • Maternal and fetal outcome associated with hemoglobin E trait and hemoglobin E disease.

    abstract::A study of 20 patients with hemoglobin E trait abnormality and 8 patients with hemoglobin E disease in pregnancy is presented. The hematologic abnormality in HbE hemoglobinopathy is mild though hemoglobin values are significantly lower than in HbA patients. Fetal wastage is no increased and the salvage rate is high (...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/00006250-197506000-00016

    authors: Ong HC

    更新日期:1975-06-01 00:00:00

  • Evaluation of carcinoma of the cervix using 111In-bleomycin.

    abstract::Indium-111 attached to bleomycin is useful in the scintigraphic localization of a variety of tumors. Since it does not normally accumulate in bowel and feces, it is superior to other radiopharmaceuticals, such as gallium-67 citrate, in the demonstration of abnormalities in the abdomen and pelvis. Twenty-eight patients...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Woolfenden JM,Waxman AD,Disaia PJ,Siemsen JK

    更新日期:1975-09-01 00:00:00

  • Uterine sarcoidosis potentially associated with interferon-alpha use for chronic hepatitis C infection.

    abstract:BACKGROUND:A regimen including interferon-alpha has become the standard of care in the treatment of chronic hepatitis C over the last decade. One rare adverse effect associated with the use of interferon-alpha is a granulomatous pulmonary reaction. CASE:A unique case of uterine sarcoidosis associated with the use of i...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/01.AOG.0000157764.44292.aa

    authors: Tsiodras S,Drimala P,Stavreas N,Dachlythras M,Alamani AM,Naoum G

    更新日期:2005-05-01 00:00:00

  • Factors affecting the consistent use of barrier methods of contraception.

    abstract:OBJECTIVES:To discuss the major issues involved in the consistent and effective use of barrier methods of contraception. DATA SOURCES:Major research and review articles on barrier methods published within the last 10 years were considered. One major source of articles was Family Planning Perspectives. METHODS OF STUD...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1016/0029-7844(96)00245-1

    authors: Beckman LJ,Harvey SM

    更新日期:1996-09-01 00:00:00

  • Increased risk of preterm birth in women with cervical conization.

    abstract:OBJECTIVE:To determine the relation between cervical conization and preterm birth. METHODS:All Danish women with singleton pregnancies who gave birth to their first infant in 1982 and second infant during the time period 1982-1987 were included in a register-based cohort study. Information on pregnancy outcome and cer...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Kristensen J,Langhoff-Roos J,Kristensen FB

    更新日期:1993-06-01 00:00:00

  • Prospective evaluation of 618 pregnant women exposed to parvovirus B19: risks and symptoms.

    abstract:OBJECTIVE:To assess the risk of maternal parvovirus B19 infection from exposure to various sources and the fetal morbidity of those infections. METHODS:We obtained demographic and occupational information about pregnant women exposed to sources of B19 and about the nature and duration of the exposures. We performed se...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(97)00701-1

    authors: Harger JH,Adler SP,Koch WC,Harger GF

    更新日期:1998-03-01 00:00:00