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Disparities/Minority Health

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Black women are more likely than other women to have pregnancy and childbirth complications

Pregnancy and childbirth complications typically range from pregnancy-induced high blood pressure, gestational diabetes, and preterm labor to infection and hemorrhage. Black women suffer from more of these problems than white, Hispanic, and Asian/Pacific Island women, according to a study supported by the Agency for Healthcare Research and Quality (HS13056). Infection, gestational diabetes, and high blood pressure are the most preventable of these problems, notes Jay J. Shen, Ph.D., of Governors State University.

Researchers examined racial disparities in adverse maternal outcomes among the four ethnic groups using data from the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) of U.S. hospital discharges on over 1 million women aged 13 to 55 who delivered babies in 1998 and 1999. Maternal outcome measures included preterm labor, hypertensive disorders of pregnancy, gestational diabetes, antepartum hemorrhage, membrane disorders, cesarean section, and postpartum hemorrhage.

Black women had a higher risk of having 10 of 11 maternal perinatal complications than white women. Black women were 71 percent more likely than white women to have preterm labor, and were more likely to experience preeclampsia, transient hypertension of pregnancy, pregnancy-induced hypertension, diabetes, placenta previa, placental abruption, premature rupture of membranes (PRM), infection of the amniotic cavity (IAC), and cesarean section. Hispanic women were more likely than white women to experience diabetes, placenta previa, IAC, and cesarean section. Asian/Pacific Islanders were more likely than other women to develop diabetes, placenta previa, PRM, IAC, and postpartum hemorrhage.

See "Disparities in maternal outcomes among four ethnic populations," by Dr. Shen, Catherine Tymkow, M.D., and Nancy MacMullen, Ph.D., in the Summer 2005 Ethnicity & Disease 15, pp. 492-497.

Editor's Note: Recognizing that race is missing in 24 percent of cases and missing for patients in specific States, AHRQ makes race/ethnicity data available to researchers on the NIS, allowing the records that include patient race/ethnicity to be used as a sample of convenience. For additional information on NIS and HCUP, go to

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