(676) Racial disparities in breastfeeding rates in postpartum patients with heart disease

To evaluate racial disparities in breastfeeding rates in postpartum patients with heart disease.

Study Design: Retrospective cohort of pregnant patients with maternal cardiac disease (MCD) managed by the University of Alabama at Birmingham (UAB) Cardio-Obstetrics Program. Patients self-identifying as Non-Hispanic Black (NHB) and Non-Hispanic White (NHW), who attended ≥ 1 prenatal visit at the UAB Cardio-Obstetrics Program and delivered at UAB hospital between March 2015 and June 2019 were included. The primary outcome was breastfeeding (BF) rate at discharge from the delivery-associated hospitalization. Secondary outcomes included BF intent on admission for delivery, BF rates at the postpartum (PP) visit, and BF rates among patients who initiated BF.

Results: One hundred thirty-eight pregnant patients with MCD were included: 58 NHB and 80 NHW patients. Multiparity, marital status and insurance type was statistically different between groups (Table 1). Government insurance was higher in NHB women than their NHW counterparts (77.6% vs. 40%; p< 0.001). Notably, mWHO classification did not differ between groups. There was significant difference in the intent to BF upon admission for the delivery-associated hospitalization (74.2% NHB vs NHW 91.3%; p=0.01), but not at hospital discharge (84.5% in NHB vs. 93.8% in NHW women; p=0.08). However, BF rates were significantly lower again among NHB at the PP visit among the entire cohort (38.2% in NHB vs. 61.1% in NHW women; p=0.036) and among those who initiated BF (35.3 % NHB vs 61.1% NHW, p=0.018).

Conclusion:

Despite similar BF rates at hospital discharge, NHB patients with MCD were less likely to express intent and continue BF at the PP visit compared to NHW patients. Qualitative studies understanding these disparities are crucial to improve BF intent and continuation, especially for NHB patients with MCD.