Racial Disparities in Breastfeeding Rates in Patients with Heart Disease

Ayamo G Oben; Christina T Blanchard; Ashton Robinson; Isabel Girling; Joanna M Joly; Marc Cribbs; Alan Tita; Brian Casey; Rachel Sinkey

doi:10.1007/s40615-024-01933-1

Racial Disparities in Breastfeeding Rates in Patients with Heart Disease

J Racial Ethn Health Disparities. 2024 Mar 20. doi: 10.1007/s40615-024-01933-1. Online ahead of print.

Authors

Ayamo G Oben^{1

2}, Christina T Blanchard^{3

4}, Ashton Robinson³, Isabel Girling³, Joanna M Joly^{3

5}, Marc Cribbs^{3

5}, Alan Tita^{3

6

4}, Brian Casey^{3

6

4}, Rachel Sinkey^{3

6

4}

Affiliations

¹ University of Alabama at Birmingham Marnix E. Heersink School of Medicine, Birmingham, AL, USA. aoben2015@gmail.com.
² Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6th Ave South, Ste 10270, Birmingham, AL, 35233, USA. aoben2015@gmail.com.
³ University of Alabama at Birmingham Marnix E. Heersink School of Medicine, Birmingham, AL, USA.
⁴ Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA.
⁵ Department of Medicine, Division of Cardiovascular Disease, University of Alabama, Birmingham, AL, USA.
⁶ Department of Obstetrics & Gynecology, University of Alabama at Birmingham, 1700 6th Ave South, Ste 10270, Birmingham, AL, 35233, USA.

PMID: 38509443
DOI: 10.1007/s40615-024-01933-1

Abstract

Objective: To evaluate racial disparities in breastfeeding rates in patients with heart disease.

Study design: Retrospective cohort of pregnant patients with maternal cardiac disease managed by a Cardio-Obstetrics program. Patients self-identifying as Non-Hispanic Black (NHB) and Non-Hispanic White (NHW), who attended ≥ 1 prenatal visit at the Cardio-Obstetrics Program and delivered at the same hospital between March 2015 and June 2019 were included. The primary outcome was breastfeeding rate at discharge from the delivery-associated hospitalization. Secondary outcomes included breastfeeding intent on admission and breastfeeding rates at the postpartum visit among patients who initiated breastfeeding.

Results: 138 pregnant patients with cardiac disease were included: 58 (42%) NHB and 80 (58%) NHW patients. Parity, marital status and insurance were statistically different between groups. NHB patients were more likely to have government insurance compared to NHW patients (77.6% vs. 40%; p < 0.001). There was a significant difference in the intent to breastfeed upon admission for the delivery-associated hospitalization (74.2% NHB vs. NHW 91.3%; p = 0.01), but not at hospital discharge (84.5% NHB vs. 93.8% NHW; p = 0.08). However, breastfeeding rates were significantly lower among NHB patients at the postpartum visit among the entire cohort (38.2% in NHB vs. 61.1% in NHW women; p = 0.036) and among those who initiated breastfeeding (35.3% NHB vs. 61.1% NHW, p = 0.018).

Conclusions: Despite similar breastfeeding rates at hospital discharge, NHB patients with maternal cardiac disease were less likely to intend to breastfeed at admission and/or continue breastfeeding by the postpartum visits. Qualitative studies understanding these differences are crucial to improve breastfeeding rates, especially for NHB patients with maternal cardiac disease.