Maternal quality and safety outcomes for Asians and Pacific Islanders in Hawai‘i: an observational study from five years of statewide data

Sentell, Tetine; Chang, Ann; Cheng, Yang; Miyamura, Jill

doi:10.1186/1471-2393-14-298

Cited by 9 publications

(7 citation statements)

References 27 publications

(44 reference statements)

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“…Differences in health outcomes are evident when Asian and Pacific Islander racial/ethnic groups are disaggregated, such as hypertension, diabetes, and obesity. [3][4][5]7,8,[19][20][21] Disaggregating Hawaiian and Pacific Islander data from the larger "Asian/Pacific Islander" category in this study allowed for both identification of disparate risks and more explicit examination of characteristics and outcomes associated with preterm birth.…”

Section: Resultsmentioning

confidence: 99%

Patterns of Preterm Birth among Women of Native Hawaiian and Pacific Islander Descent

2018

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Objective To describe the characteristics and risk factors for preterm birth in Hawaiian and Pacific Islander women. Study Design Retrospective cohort study of 10,470 women of Hawaiian or Pacific Islander descent drawn from a population-based birth cohort dataset in California. Variables were examined across preterm birth subtype (spontaneous, provider initiated) and by gestational age grouping (early preterm birth and late preterm birth) and all preterm births. Results Hawaiian/Pacific Islander women were at higher risk for preterm birth when they had fewer than three prenatal visits; were underweight, reported tobacco, alcohol, or illicit drugs use in pregnancy; had a diagnosis of anemia, gestational diabetes, preexisting diabetes, or hypertension with or without pre-eclampsia; or had a history of previous preterm birth. Obesity was found to be protective for preterm birth. Conclusion Women of Hawaiian and Pacific Islander descent demonstrate a similar yet unique constellation of risk and protective factors for preterm birth as compared with other groups at high risk for preterm birth. Interventions aimed to prevent preterm birth need to support the specific needs of this population.

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Section: Resultsmentioning

confidence: 99%

Patterns of Preterm Birth among Women of Native Hawaiian and Pacific Islander Descent

2018

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“…They summarize possible contributing factors mentioned by researchers as labor and birthing management techniques, communication, cultural differences, acculturation, fear, or influence of the birth attendant (particularly the attendant’s experience level). Sentell and colleagues [ 24 ] examined 5 years of statewide API data in Hawaii. Compared with White patients, Japanese, Filipino, and other Pacific Islanders had significantly higher overall delivery complication rates, whereas Native Hawaiians had significantly lower rates.…”

Section: Discussionmentioning

confidence: 99%

“…Estimates of risk-adjusted mortality and obstetric trauma among API language subgroups are examples with clearer implications. Studies using disaggregated API ethnicities and languages found large variations in health care quality, access, utilization, and outcomes [ 24 , 29 , 30 , 31 , 32 , 33 ]. The findings of this study, which demonstrate that aggregation masks significant subgroup variation, support the collection and reporting of more granular data for research, evaluations, and targeted interventions.…”

Section: Discussionmentioning

confidence: 99%

Disparities in Rates of Inpatient Mortality and Adverse Events: Race/Ethnicity and Language as Independent Contributors

Hines

Andrews

Moy

et al. 2014

IJERPH

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Patients with limited English proficiency have known limitations accessing health care, but differences in hospital outcomes once access is obtained are unknown. We investigate inpatient mortality rates and obstetric trauma for self-reported speakers of English, Spanish, and languages of Asia and the Pacific Islands (API) and compare quality of care by language with patterns by race/ethnicity. Data were from the United States Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, 2009 State Inpatient Databases for California. There were 3,757,218 records. Speaking a non-English principal language and having a non-White race/ethnicity did not place patients at higher risk for inpatient mortality; the exception was significantly higher stroke mortality for Japanese-speaking patients. Patients who spoke API languages or had API race/ethnicity had higher risk for obstetric trauma than English-speaking White patients. Spanish-speaking Hispanic patients had more obstetric trauma than English-speaking Hispanic patients. The influence of language on obstetric trauma and the potential effects of interpretation services on inpatient care are discussed. The broader context of policy implications for collection and reporting of language data is also presented. Results from other countries with and without English as a primary language are needed for the broadest interpretation and generalization of outcomes.

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“…22,23 Native Hawaiian/Other Pacific Islander women have higher rates than non-Hispanic White women of postpartum hemorrhage, 24 preeclampsia, 25 gestational diabetes, 26 and delivery complications. 27 Studies on severe maternal morbidity in Hawai'i are scarce, and the possible associations between severe maternal morbidity and race/ethnicity remain to be clarified. The primary objective of our study was to describe racial/ethnic disparities in severe maternal morbidity during pregnancy and the postpartum period in Hawai'i by using admission to an ICU as a marker.…”

mentioning

confidence: 99%

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confidence: 99%

Racial/Ethnic Disparities in Intensive Care Admissions in a Pregnant and Postpartum Population, Hawai‘i, 2012-2017

2021

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Objective Maternal morbidity and mortality is a global concern despite advances in medical care and technology and improved economic resources of nations worldwide. The primary objective of our study was to describe racial/ethnic disparities in severe maternal morbidity by using admission to an intensive care unit (ICU) as a marker. The secondary objective was to evaluate associations between patient characteristics, including obstetric outcomes, and severe maternal morbidity. Methods This retrospective cohort study used a large inpatient database to identify pregnancy and postpartum hospitalizations in Hawai‘i from January 2012 through September 2017. We evaluated associations between sociodemographic and clinical characteristics and race/ethnicity by using χ2 tests. We used multivariable logistic regression to assess associations between race/ethnicity and ICU admission. We used a post hoc analysis to assess associations between ICU admission and obstetric outcomes by race/ethnicity. Results After adjustment, we found a significantly higher ICU admission rate among Asian (adjusted odds ratio [aOR] = 1.30; 95% CI, 1.04-1.62; P = .02), Filipino (aOR = 1.45; 95% CI, 1.17-1.79; P < .001), and Native Hawaiian/Other Pacific Islander (aOR = 1.39; 95% CI, 1.15-1.68; P < .001) women compared with non-Hispanic White women. Multiple clinical characteristics and outcomes were associated with ICU admission, such as preexisting chronic conditions and pregnancy-induced hypertensive disorders. Conclusion We found that severe maternal morbidity represented by ICU admission is higher among Asian, Filipino, and Native Hawaiian/Other Pacific Islander women than among non-Hispanic White women in Hawai’i. Our findings reemphasize the need for health care providers to be vigilant in caring for members of racial/ethnic minority groups and managing their comorbidities.

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Maternal quality and safety outcomes for Asians and Pacific Islanders in Hawai‘i: an observational study from five years of statewide data

Cited by 9 publications

References 27 publications

Patterns of Preterm Birth among Women of Native Hawaiian and Pacific Islander Descent

Patterns of Preterm Birth among Women of Native Hawaiian and Pacific Islander Descent

Disparities in Rates of Inpatient Mortality and Adverse Events: Race/Ethnicity and Language as Independent Contributors

Racial/Ethnic Disparities in Intensive Care Admissions in a Pregnant and Postpartum Population, Hawai‘i, 2012-2017

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