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CC BY-NC-ND 4.0 · AJP Rep 2024; 14(01): e57-e61
DOI: 10.1055/s-0043-1778000
Original Article

Maternal and Neonatal Morbidities by Race in College-Educated Women

Adina R. Kern-Goldberger 
1   Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York
,
Nigel Madden
1   Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York
,
Caitlin Baptiste
1   Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York
2   Division of Maternal-Fetal Medicine, Columbia University Irving Medical Center, New York, New York
,
Alexander Friedman
1   Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York
2   Division of Maternal-Fetal Medicine, Columbia University Irving Medical Center, New York, New York
,
Cynthia Gyamfi-Bannerman
1   Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York
2   Division of Maternal-Fetal Medicine, Columbia University Irving Medical Center, New York, New York
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Abstract

Objective Non-Hispanic black and Hispanic women experience significantly higher adverse maternal and neonatal outcomes compared with non-Hispanic white women. The purpose of this study is to explore whether disparities in obstetric outcomes exist by race among women who are college-educated.

Study Design This is a retrospective cohort study from a multicenter observational cohort of women undergoing cesarean delivery. Women were defined as “college-educated” if they reported completion of a 4-year college degree. Race/ethnicity was categorized as non-Hispanic white, non-Hispanic black, Hispanic, Asian, Native American, or unknown. The primary outcome was a composite of maternal morbidity, and a composite of neonatal morbidity was evaluated as a secondary outcome. A multivariable logistic regression model was then utilized to assess associations of race with the primary and secondary outcomes.

Results A total of 2,540 women were included in the study. After adjusting for potential confounding variables, maternal morbidity was found to be significantly higher for college-educated non-Hispanic black women compared with non-Hispanic white women (odds ratio [OR] 1.77, 95% confidence interval [CI] 1.12–2.80). The incidence of neonatal morbidity was significantly higher for non-Hispanic black (OR 1.91, 95% CI 1.31–2.79) and Hispanic (OR 3.34, 95% CI 2.23–5.01) women.

Conclusion In this cohort, the odds of cesarean-related maternal and neonatal morbidities were significantly higher for college-educated non-Hispanic black women, compared with their non-Hispanic white counterparts. This demonstrates that even among women with higher level education, racial and ethnic disparities persist in obstetric outcomes.

Keywords

racial disparities - maternal morbidity - neonatal morbidity - education

Note

This study was presented at the Society for Reproductive Investigation 66th Annual Scientific Meeting in Paris, France (Abstract# 2199).




Publication History

Received: 15 July 2020

Accepted: 22 October 2023

Article published online:
29 January 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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