Increased Perinatal Morbidity and Mortality Among Asian American and Pacific Islander Women in the United States

Abstract

Despite having a higher socioeconomic status, AAPI women had higher rates of maternal mortality during hospitalization for delivery. This increase persisted even after adjustment for factors known to affect peripartum outcomes. Further investigation is needed to better clarify the causes of racial differences in maternal morbidity and mortality.

The association between race/ethnicity and peripartum hysterectomy and the risk of perioperative complications

“…Similarly, Bryant et al 7 observed racial differences in postpartum hemorrhage due to uterine atony requiring peripartum hysterectomy, but their models did not include hospital region, 7 which attenuated the present study’s observed association between race and peripartum hysterectomy among black women. The findings in the present study of a 2–3‐fold increased risk of maternal death for women of color after peripartum hysterectomy is similar to previously reported elevated rates of all‐cause pregnancy‐related mortality for these racial/ethnic groups 10,39 . The present study’s finding of higher odds of perioperative complications among non‐white peripartum hysterectomy recipients is also largely consistent with prior studies 7,10,40 and may point to differences in care.…”

“…The findings in the present study of a 2–3‐fold increased risk of maternal death for women of color after peripartum hysterectomy is similar to previously reported elevated rates of all‐cause pregnancy‐related mortality for these racial/ethnic groups 10,39 . The present study’s finding of higher odds of perioperative complications among non‐white peripartum hysterectomy recipients is also largely consistent with prior studies 7,10,40 and may point to differences in care. While previous work demonstrated that childbirth hospitalizations complicated by severe maternal morbidity were more costly than those without, those analyses included costs for hospitalizations where patients did not have peripartum hysterectomy 41 .…”

“…The estimated rate of peripartum hysterectomy in the present study was largely consistent with most prior work 6,7,10,31,32 but inconsistent with others 11,33–36 . Those studies were single‐site analyses, 11,35,36 included low‐risk populations, 34 or were from international cohorts 33 .…”

“…2 In the USA, women of color experience higher rates of severe maternal morbidity [3][4][5][6][7] and death during and after pregnancy. Although race/ ethnicity is known to be associated with disparate outcomes in nonobstetric hysterectomy care, 8,9 the relationship between race/ethnicity and peripartum hysterectomy 6,[10][11][12] or its related outcomes 10 is not well-explored. Recent publications focus on differences in outcomes after peripartum hysterectomy based on hospital characteristics, without examining disparities among minority groups, 13,14 or they have combined peripartum hysterectomy with other maternal morbidity outcomes.…”

The Association between Adequate Prenatal Care and Severe Maternal Morbidity: A Population-based Cohort Study

“…동반질환 (Lindquist et al, 2014), (Grobman et al, 산과적 합병증 2014), Norhayati et al, 2016;Kominiarek et al, 2017;Siddiqui et al, 2017), 다태아 (Martin et al, 2016;Santana et al, 2016;Witteveen 제왕절개 et al, 2016), (Grobman et al, 2014;Lindquist 조산 et al, 2014;Norhayati et al, 2016), (…”