Racial differences in asthma morbidity during pregnancy

Area of Science:

• Reproductive Health
• Pulmonology
• Health Disparities

Background:

• Asthma management during pregnancy is crucial for maternal and fetal well-being.
• Limited data exists on racial disparities in asthma outcomes among pregnant women, particularly in low-income populations.
• Understanding these disparities is essential for targeted interventions and equitable healthcare.

Purpose of the Study:

• To estimate racial differences in maternal asthma outcomes.
• To compare asthma-related morbidity between Black and White pregnant women with similar access to healthcare.
• To identify potential areas for improving care for low-income pregnant women with asthma.

Main Methods:

• Population-based cohort study utilizing Tennessee's Medicaid Program (TennCare) enrollment data linked to birth certificates (1995-2001).
• Identification of pregnant women with asthma using International Classification of Diseases, 9th Revision (ICD-9) codes and pharmacy records.
• Comparison of adjusted relative rates for rescue corticosteroid prescriptions, emergency department visits, and hospitalizations by race using Poisson regression.

Main Results:

• A cohort of 4,315 pregnant women with asthma was identified from 112,171 women.
• Black women were more likely than White women to receive rescue corticosteroids (adjusted RR 1.35).
• Black women experienced higher rates of emergency department visits (adjusted RR 1.89) and asthma hospitalizations (adjusted RR 1.73) compared to White women.

Conclusions:

• Pregnant women with asthma exhibit high rates of asthma-related morbidity.
• Black pregnant women experience significantly greater asthma-related morbidity than White pregnant women.
• There is an urgent need to improve asthma care for low-income pregnant women, with a particular focus on Black women.