Labor and delivery unit practices and racial and ethnic disparities in severe maternal and neonatal morbidity among nulliparous individuals with low-risk pregnancies - Summary - MDSpire
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Labor and delivery unit practices and racial and ethnic disparities in severe maternal and neonatal morbidity among nulliparous individuals with low-risk pregnancies
To assess racial and ethnic differences in hospital practices and their contribution to disparities in severe maternal and neonatal morbidity among low-risk nulliparous individuals (first-time mothers).
Key Findings:
Black and Latino individuals had the lowest proportion of births at lower-interventional hospitals (17% and 16%, respectively) out of 348,990 low-risk live births.
American Indian and Alaska Native (AI/AN) individuals experienced the highest rates of severe maternal and neonatal morbidity.
Counterfactual analysis indicated that if all births occurred at lower-interventional hospitals, racial and ethnic disparities in outcomes would modestly increase, except for severe neonatal morbidity among AI/AN individuals.
Interpretation:
The study highlights significant racial and ethnic disparities in access to lower-interventional labor and delivery practices, which may exacerbate maternal and neonatal morbidity, underscoring the need for systemic changes.
Limitations:
The study is limited to California hospitals and may not be generalizable to other regions.
Data on labor and delivery practices may not capture all relevant factors influencing outcomes, and potential biases in survey responses could affect results.
Conclusion:
Addressing disparities in hospital practices is crucial for improving maternal and neonatal health outcomes among racially and ethnically minoritized groups.
by Stephanie A Leonard, Xiao Xu, Shantay Davies-Balch, Elliott K Main, Brian T Bateman, David H Rehkopf, Henry C Lee, Jessica Illuzzi, Irogue Igbinosa, Ijeoma Iwekaogwu, Deirdre J Lyell
The expert panel outlines surveillance, device management, and diagnostic stewardship strategies to address both catheter-associated and non–catheter-associated infections.
