Jay J. Shen, PhD¹, Catherine Tymkow, ND², and Nancy MacMullen, PhD². (1) Department of Health Administration, College of Health Professions, Governors State University, One University Parkway, University Park, IL 60466, (708)235-2131, j-shen@govst.edu, (2) Nursing, Governors State University, One University Parkway, University Park, IL 60466

Although racial disparities in adverse neonatal outcomes have been investigated, limited research has been done on racial disparities related to adverse maternal outcomes. This study examined racial disparities in adverse maternal outcomes among four major ethnic groups. A total of 1,030,350 women aged 13 to 55 who had a delivery in 1998 and 1999, identified from the National Inpatient Sample. The data contained 62% whites, 18% African Americans, 18% Hispanics, and 4% Asians / Pacific Islanders. Eleven maternal outcome measures were examined. Maternal age, comorbidities, health insurance status and hospital characteristics were adjusted. Compared to whites: (a) African-Americans had a higher risk of having preterm labor (Odds Ratio [OR] 1.71), preeclampsia (OR 1.59), transient hypertension of pregnancy (THP) (OR 1.13), pregnancy-induced hypertension (PIH) (OR 1.38), diabetes (OR 1.26), placenta previa (OR 1.78), placental abruption (OR 1.52), premature rupture of membranes (PRM) (OR 1.19), infection of the amniotic cavity (IAC) (OR 1.95), and cesarean section (OR 1.12), but had a lower risk of having postpartum hemorrhage (OR 0.89); (b) Hispanics were more likely to have diabetes (OR 1.44), placenta previa (OR 1.20), IAC (OR 1.15), and cesarean section (OR 1.08), but less likely to have preterm labor (OR 0.89), THP (OR 0.63), PIH (OR 0.79), abruption placenta (OR 0.86), PRM (OR 0.87), and postpartum hemorrhage (OR 0.87); and (c) Asians / Pacific Islanders were more likely to have diabetes (OR 2.05), placenta previa (OR 1.57) PRM (OR 1.26), IAC (1.79) and postpartum hemorrhage (OR 1.19), but less likely to have THP (OR 0.67), PIH (OR 0.73), and cesarean section (OR 0.82). Maternal infection and gestational diabetes are the most significant preventable risk factors contributing to racial disparities. Emphasis should be given to proper nutrition, exercise and prompt prenatal care beginning prior to the pregnancy and continuing throughout the pregnancy for minority women. Since African Americans had poorer outcomes than whites in 10 out of 11 measures, public policy should specifically target this population. Interventions that limit access to tobacco and alcohol while promoting access to high quality, nutritious food and safe facilities for exercise in the population are likely to improve preconceptional health status leading to improved maternal outcomes.

Learning Objectives:

• Identify the most vulnerable ethnic populations among pregnant women.
• Understand how improving access to care for prenatal care can provide opportunities to eliminate racial disparities and reduce health care cost.
• Realize how policy makers, health care oversight agencies, and accrediting bodies can stimulate efforts by health care organizations to eliminate racial disparities.

Keywords: Health Disparities, Women's Health

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Research grant from Agency for Healthcare Research and Quality