Postpartum hemorrhage outcomes and race

Area of Science:

• Obstetrics and Gynecology
• Maternal Health
• Health Disparities Research

Background:

• The association between race and adverse outcomes in postpartum hemorrhage (PPH) is not well understood.
• Existing research lacks comprehensive data on racial disparities in PPH complications.

Purpose of the Study:

• To investigate the relationship between race and adverse maternal outcomes in women experiencing postpartum hemorrhage.
• To quantify racial differences in severe morbidity and mortality following PPH.

Main Methods:

• Retrospective cohort study using the National (Nationwide) Inpatient Sample (NIS) from 2012-2014.
• Analysis included women aged 15-54 with a diagnosis of PPH, categorizing race/ethnicity.
• Log-linear regression models assessed severe morbidity risk, stratified by comorbidity, with risk ratios and 95% confidence intervals.

Main Results:

• Non-Hispanic Black women had significantly higher severe morbidity risk (26.6%) compared to other racial groups.
• Non-Hispanic Black women showed increased risk for disseminated intravascular coagulation and transfusion.
• While Black women had higher hysterectomy risk than non-Hispanic white women, Asian/Pacific Islander women had the highest risk; Black women also faced significantly higher mortality risk.

Conclusions:

• Black women experience disproportionately higher rates of severe morbidity and mortality associated with postpartum hemorrhage.
• Racial disparities in PPH outcomes persist even after adjusting for comorbidities.
• Findings underscore the critical need to address systemic factors contributing to these adverse maternal health outcomes.