Within the same New York City hospital, black and Latina women are at higher risk for severe maternal morbidity than white women, according to a study published online Jan. 9 in Obstetrics & Gynecology.
Elizabeth A. Howell, M.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues using linked New York City discharge and birth certificate data sets (591,455 deliveries from 2010 to 2014) to examine within-hospital black-white, Latina-white, and Medicaid-commercially insured differences in severe maternal morbidity.
The researchers found that severe maternal morbidity was higher among black and Latina women versus white women (4.2 and 2.9 percent, respectively, versus 1.5 percent). There was also a difference between women insured by Medicaid versus those commercially insured (2.8 versus 2.0 percent). However, women insured by Medicaid versus those with commercial insurance had a similar risk for severe maternal morbidity within the same hospital. In conditional logit analyses, the investigators also found that compared with white women, black and Latina women had a higher risk for severe maternal morbidity (adjusted odds ratios, 1.52 and 1.44, respectively), while women insured by Medicaid had a similar risk to those who are commercially insured.
"Our findings raise the hypothesis that other factors such as implicit bias, communication skills, structural racism, and different care patterns may contribute to our findings of racial and ethnic disparities within hospitals," the authors said in a statement.