• Virginia E Tangel, Kathy C Matthews, Sharon E Abramovitz, and Robert S White.
• Weill Cornell Medicine, Center for Perioperative Outcomes, Department of Anesthesiology, 428 East 72nd Street, Suite 800A, New York, NY 10021, United States of America. Electronic address: vit2010@med.cornell.edu.
• J Clin Anesth. 2020 Oct 1; 65: 109821.

Study ObjectiveTo evaluate racial and ethnic disparities in severe maternal morbidity (SMM) and administered anesthesia techniques.DesignRetrospective cohort study.SettingAdministrative database study using 2007-2014 data from California, Florida, New York, Maryland, and Kentucky from the State Inpatient Databases (SID), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality (AHRQ).Patients6,879,332 parturients aged ≥18 years old who underwent deliveries were identified by International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) codes: V27.0 and V27.1 for singleton deliveries, and V27.2 through V27.8 for multiple births.InterventionsPatients who had a singleton or multiple delivery.MeasurementsPatients were cohorted by race/ethnicity: white (reference category), black, Hispanic, other, or missing. Demographic characteristics and comorbidities were compared. Adjusted odds ratios with generalized linear mixed modeling were calculated for SMM. We also conducted additional exploratory analyses of racial/ethnic disparities in the anesthesia technique used for cesarean deliveries, as well as the use of analgesia in vaginal deliveries.Main ResultsWhen controlling for patient demographics, comorbidities, and hospital characteristics, black women were more likely than white women to experience any SMM (adjusted odds ratio: 1.38, 95% CI: 1.35-1.41). This finding was consistent in stratified analyses. Black women were also more likely than white women to receive general anesthesia for cesarean delivery (aOR: 1.44, 95% CI: 1.39-1.49) and to receive no analgesia for vaginal delivery (aOR: 1.45, 95% CI: 1.43-1.47).ConclusionsOur findings highlight the differences in outcomes and care for black as compared to white parturients related to SMM and administered anesthesia techniques.Copyright © 2020 Elsevier Inc. All rights reserved.

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