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APHA Scientific Session and Event Listing

Recorded presentation

Li Liu, MBBS, MHS¹, Rosanna Setse, MD, MPH², Ruby Grogan², Donna Strobino, PhD³, Harold Fox, MD², Neil Powe, MD, MPH, MBA⁴, and Wanda Nicholson, MD, MPH². (1) Population and Family Health, Johns Hopkins School of Public Health, 1620 McElderry Street, Room 11D4, Baltimore, MD 21205, 410-502-6386, liliu@jhsph.edu, (2) Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, 600 N Wolfe Street, Phipps Building, Room 247, Baltimore, MD 21287, (3) Department of Population and Family Health Sciences, Johns Hopkins School of Public Health, 615 N. Wolfe St., Room E4151, Baltimore, MD 21205, (4) Epidemiology, Johns Hopkins School of Public Health, 2024 E. Monument, Suite 2-600, Baltimore, MD 21205

Objective: Despite the abundance of research on racial disparities in birth outcomes, few have examined racial disparities in health-related quality of life (HRQoL) among pregnant women. Our objectives were to identify racial differences in HRQoL and estimate the independent association of race with HRQoL during pregnancy.

Methods: Longitudinal study of 198 pregnant women in Baltimore City starting in the first trimester. The Medical Outcomes Study Short Form (SF-36) was administered in each trimester and the postpartum period. The outcome was HRQoL scores from the 8 domains of the MOS at each follow-up. The independent variable was race (black versus white). We used generalized estimating equations to estimate the independent effect of race on each of the HRQoL.

Results: At baseline 60% of the women were black and 40% were white. Average maternal age was 28 yrs ±7. In unadjusted analysis, black women had significantly lower HRQoL scores compared to white women for all 8 domains (P < 0.05). After adjustment for socio-demographics, depressive symptoms, social support and obstetrical complications, black women had HRQoL scores that were 23 points lower in Physical Functioning, 35 points lower in Role Physical, 20 points lower in Bodily Pain, 19 points lower in Vitality, 26 points lower in Social Functioning, 29 points lower in Role Emotional and 11 points lower in Mental Health throughout pregnancy.

Conclusions: Black race is associated with worse HRQoL in many aspects during pregnancy. The reasons for these disparities should be explored and interventions developed to correct them.

Learning Objectives:

• Examine racial differences in health-related quality of life
• Examine the effect of race on HRQoL throughout the course of pregnancy, adjusting for socio-demographic and clinical factors
• Recognize the prenatal care implications of disparities in HRQoL during pregnancy
• Discuss implementing interventions that target African-American women.

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation