Maternal and Neonatal Morbidities by Race in College-Educated Women

Adina R Kern-Goldberger; Nigel Madden; Caitlin Baptiste; Alexander Friedman; Cynthia Gyamfi-Bannerman

doi:10.1055/s-0043-1778000

Maternal and Neonatal Morbidities by Race in College-Educated Women

AJP Rep. 2024 Jan 29;14(1):e57-e61. doi: 10.1055/s-0043-1778000. eCollection 2024 Jan.

Authors

Adina R Kern-Goldberger¹, Nigel Madden¹, Caitlin Baptiste^{1

2}, Alexander Friedman^{1

2}, Cynthia Gyamfi-Bannerman^{1

2}

Affiliations

¹ Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York.
² Division of Maternal-Fetal Medicine, Columbia University Irving Medical Center, New York, New York.

Abstract

Objective Non-Hispanic black and Hispanic women experience significantly higher adverse maternal and neonatal outcomes compared with non-Hispanic white women. The purpose of this study is to explore whether disparities in obstetric outcomes exist by race among women who are college-educated. Study Design This is a retrospective cohort study from a multicenter observational cohort of women undergoing cesarean delivery. Women were defined as "college-educated" if they reported completion of a 4-year college degree. Race/ethnicity was categorized as non-Hispanic white, non-Hispanic black, Hispanic, Asian, Native American, or unknown. The primary outcome was a composite of maternal morbidity, and a composite of neonatal morbidity was evaluated as a secondary outcome. A multivariable logistic regression model was then utilized to assess associations of race with the primary and secondary outcomes. Results A total of 2,540 women were included in the study. After adjusting for potential confounding variables, maternal morbidity was found to be significantly higher for college-educated non-Hispanic black women compared with non-Hispanic white women (odds ratio [OR] 1.77, 95% confidence interval [CI] 1.12-2.80). The incidence of neonatal morbidity was significantly higher for non-Hispanic black (OR 1.91, 95% CI 1.31-2.79) and Hispanic (OR 3.34, 95% CI 2.23-5.01) women. Conclusion In this cohort, the odds of cesarean-related maternal and neonatal morbidities were significantly higher for college-educated non-Hispanic black women, compared with their non-Hispanic white counterparts. This demonstrates that even among women with higher level education, racial and ethnic disparities persist in obstetric outcomes.

Keywords: education; maternal morbidity; neonatal morbidity; racial disparities.

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