Racial and Ethnic Disparities in the Incidence of Severe Maternal Morbidity in the United States, 2012–2015

Abstract

OBJECTIVE: To describe racial and ethnic disparities in the incidence of severe maternal morbidity during delivery hospitalizations in the United States. METHODS: We conducted a pooled, cross-sectional analysis of 2012–2015 data from the National Inpatient Sample to define the prevalence of chronic conditions and incidence of severe maternal morbidity among deliveries to non-Hispanic white, non-Hispanic black, Hispanic, Asian or Pacific Islander, and Native American or Alaska Native women. We used weighted multivariable logistic regression and predictive margins to generate prevalence and incidence estimates. Adjusted rate ratios and differences were calculated to quantify disparities across racial and ethnic categories. Subgroup analyses were performed to examine the incidence of severe maternal morbidity among deliveries to women with comorbid physical health conditions, behavioral health conditions, and multiple chronic conditions within each racial and ethnic category. RESULTS: The incidence of severe maternal morbidity was significantly higher among deliveries to women in every racial and ethnic minority category compared with deliveries among non-Hispanic white women. Severe maternal morbidity occurred in 231.1 (95% CI 223.6–238.5) and 139.2 (95% CI 136.4–142.0) per 10,000 delivery hospitalizations among non-Hispanic black and non-Hispanic white women, respectively ( P