Racial disparities in reported prenatal care advice from health care providers.

Kogan, Michael D.; Kotelchuck, Milton; Alexander, Greg R.; Johnson, Wayne E.

doi:10.2105/ajph.84.1.82

Cited by 184 publications

(96 citation statements)

References 21 publications

(5 reference statements)

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“…Brett et al 17 showed that black mothers with multiple gestation pregnancies are less likely to receive tocolysis (adjusted relative risk 0.69) compared to white mothers. Our data are also consistent with the research of Kogan et al 18 who showed that white mothers are more likely not to receive prenatal advice Data are expressed as odd (95% confidence) of white mothers compared to black mothers. a Unless listed as excluded in the models, the models controlled for gestational age, multiple gestation pregnancies, clinical chorioamnionitis, preterm labor, maternal age, year of birth, income, and presentation.…”

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confidence: 92%

Racial differences in prenatal care of mothers delivering very low birth weight infants

et al. 2006

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Objectives: To determine whether there are any racial differences in the prenatal care of mothers delivering very low birth weight infants (VLBW).Study Design: Retrospective cohort study of infants cared for at a single regional level III neonatal intensive care unit over a 9-year period, July 1993-June 2002, N ¼ 1234. The main outcome variables investigated included antenatal administration of steroids, delivery by cesarean section, and use of tocolytic medications. Both univariate and multivariate analyses were performed.Results: After controlling for potential confounding variables, white mothers delivering VLBWs had an increased odds of cesarean delivery (odds ratio 1.5, 95% confidence intervals (CI) 1.1-2.0), receiving antenatal steroids (1.3, CI 1.01-1.8), and tocolysis (1.4, CI 1.1-2.0) compared to black mothers. The models controlled for gestational age, multiple gestation, premature labor, clinical chorioamnionitis, maternal age, income, year of birth, and presentation.Conclusions: In our population of VLBWs, white mothers are more likely to receive antenatal steroids, tocolytic medications, and deliver by cesarean section when compared to black mothers. From our data we cannot determine the reasons behind these racial differences in care of mothers delivering VLBWs.

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confidence: 92%

Racial differences in prenatal care of mothers delivering very low birth weight infants

et al. 2006

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“…However, this finding also may represent physician bias in the management of patients belonging to different racial/ethnic groups, which has been observed in several prior studies in the adult population. [33][34][35][36] Although adjusted results indicated fewer bacterial diagnoses for African American and Latino patients, compared with non-Hispanic white patients, this did not translate to lower adjusted rates of receiving antibiotics. This may indicate that these groups were more likely to receive antibiotics for inappropriate indications (ie, nonbacterial illnesses).…”

Section: Discussionmentioning

confidence: 99%

Racial/Ethnic Variation in Parent Expectations for Antibiotics: Implications for Public Health Campaigns

et al. 2004

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ABSTRACT. Context. Widespread overuse and inappropriate use of antibiotics are a major public health concern. Little is known about racial/ethnic differences in parents seeking antibiotics for their children's upper respiratory illnesses.Objective. To examine racial/ethnic differences in parent expectations about the need for antibiotics and physician perceptions of those expectations.Design. We conducted a nested, cross-sectional survey of parents who were coming to see their child's pediatrician because of cold symptoms between October 2000 and June 2001. Parents completed a previsit survey that collected information on demographics, their child's illness, and a 15-item previsit expectations inventory that included an item asking how necessary it was for the physician to prescribe antibiotics. Physicians completed a postvisit survey that collected information on diagnosis, treatment, and whether the physician perceived the parent expected an antibiotic. The encounter was the unit of analysis. Multivariate logistic regression analyses were performed to evaluate predictors of dichotomized parental expectations for antibiotics, dichotomized physician perceptions of those expectations, diagnostic patterns, and antibiotic-prescribing patterns.Setting. Twenty-seven community pediatric practices in the Los Angeles, Calif, metropolitan area.Participants. A volunteer sample of 38 pediatricians (participation rate: 64%) and a consecutive sample of 543 parents (participation rate: 83%; ϳ15 participating for each enrolled pediatrician) seeking care for their children's respiratory illnesses. Pediatricians were eligible to participate if they worked in a community-based managed care practice in the Los Angeles area. Parents were eligible to participate if they could speak and read English and presented to participating pediatricians with a child 6 months to 10 years old who had cold symptoms but had not received antibiotics within 2 weeks.Main Outcome Measures. Parental beliefs about the necessity of antibiotics for their child's illness, physician perceptions of parental expectations for antibiotics, bacterial diagnosis rates, and antibiotic-prescribing rates.Results. Forty-three percent of parents believed that antibiotics were definitely necessary, and 27% believed that they were probably necessary for their child's illness. Latino and Asian parents were both 17% more likely to report that antibiotics were either definitely or probably necessary than non-Hispanic white parents. Physicians correctly perceived that Asian parents expected antibiotics more often than non-Hispanic white parents but underestimated the greater expectations of Latino parents for antibiotics. Physicians also correctly perceived that parents of children with ear pain or who were very worried about their child's condition were significantly more likely to expect antibiotics. Physicians were 7% more likely to make a bacterial diagnosis and 21% more likely to prescribe antibiotics when they perceived that antibiotics were expected.Conclusions. Paren...

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“…Kogan et al 34 studied the advice given to 8310 women during pregnancy and found that a large percentage of women did not receive any counseling about smoking, drinking, or illicit drug use. Another study noted that physicians were unaware of substance abuse problems in 45% of their clients who were presenting at drug treatment programs.…”

Section: Discussionmentioning

confidence: 99%