662: Racial disparities in preeclampsia and growth restriction persist among women of high socioeconomic status (SES)
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY(2020)
摘要
Despite persistent racial disparities in placentally mediated adverse outcomes [gestational hypertension (GHTN ± preeclampsia (PREE), small for gestational age (SGA)] in the US among non-Hispanic (NH) black women compared to NH white women, it is controversial whether sociodemographic factors can explain these differences. We sought to evaluate whether disparities in GHTN ± PREE and SGA persist among women of high SES. We conducted a population-based cohort study using US live birth records from the National Vital Statistics System, 2015-2017.We included singleton, non-anomalous pregnancies among women of high SES (those with ≥ 16 years of education and private insurance and not receiving Women, Infants and Children [WIC] benefits) and who identified as NH white, NH black, or both NH black & white races.The primary outcome was the diagnosis of GHTH ± PREE. The secondary outcome was SGA (birthweight < 10% and < 3% for fetal gender & gestational age). Data were analyzed using chi-square, t-test, and logistic regression. Of 11,376,439 singleton, non-anomalous pregnancies during the study period, 2,170,686 (19.1%) pregnancies met inclusion criteria; 92.9% were NH white, 6.7% NH black, and 0.4% both NH white & black races. Overall, 6.1% were diagnosed with GHTN ± PREE, 3.7% with SGA < 10%, and 0.7% with SGA < 3%. Baseline characteristics and outcomes are compared by race (Table 1). In unadjusted analyses, rates of GHTN ± PREE, SGA < 10%, and SGA < 3% were higher for women of NH black and both NH black & white races compared to women of NH white race alone. In regression models, NH black women and those with mixed NH black and NH white race had a higher odds of GHTN ± PREE and SGA (Figure 1). Among college-educated U.S. women with private insurance who are not receiving WIC, racial disparities in placentally mediated adverse outcomes in pregnancy persist. These findings suggest that factors other than socio-demographics are important in the underlying pathogenesis of placentally-mediated adverse pregnancy outcomes.View Large Image Figure ViewerDownload Hi-res image Download (PPT)
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关键词
preeclampsia,racial disparities,high socioeconomic status,growth restriction
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