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Severe maternal morbidity and Black-white differences in Washington State
Bharti Garg1, Alyssa Hersh1, Aaron B Caughey1
1Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, OR, USA.
Summary
Black women face higher severe maternal morbidity (SMM) rates. This risk is elevated in hospitals serving a higher proportion of Black women, indicating a need to address disparities.
Area of Science:
- Maternal Health
- Health Disparities
- Public Health
Background:
- Severe maternal morbidity (SMM) rates are disproportionately higher among Black women.
- Existing data suggests these disparities may be exacerbated in hospitals with a higher concentration of Black patients.
Purpose of the Study:
- To investigate if Black women experience higher SMM rates in Washington State.
- To determine if SMM rates vary based on the proportion of Black women served by a hospital.
Main Methods:
- A retrospective cohort study utilized linked birth-hospital discharge data from Washington State.
- Hospitals were categorized into low, medium, and high Black-serving based on delivery proportions.
- Multivariable logistic regression adjusted for demographics, comorbidities, and hospital clustering.
Main Results:
- The overall SMM rate was 1.12% (4556/407,808 women).
- High Black-serving hospitals exhibited the highest SMM rates (1.94%) compared to medium (1.16%) and low (1.06%) (p < .01).
- Black women had increased odds of SMM (OR = 1.58), which remained significant after adjustments (aOR = 1.29).
Conclusions:
- Black women face a significantly higher risk of severe maternal morbidity.
- Addressing hospital-level performance and outcomes stratified by race is crucial for reducing disparities and improving maternal health outcomes.
