(578) Racial and Ethnic Disparities in Severe Maternal Morbidity During Delivery Hospitalization in Northeast Pennsylvania

Objective: To compare rates of severe maternal morbidity (SMM) during delivery hospitalization among racial and ethnic groups at Lehigh Valley Health Network (LVHN) and to determine if there is a significant relationship between age, primary language, and SMM.

Study Design: Retrospective analysis of patients who delivered between January 2016-December 2020. Data was obtained from LVHN’s electronic medical record. SMM was defined by having a diagnosis of a Centers for Disease Control and Prevention defined SMM indicator. To stratify severity of disease, transfusion was made an indicator only if transfused > 4 units of packed red blood cells. Race was classified as White or non-White, and ethnicity as Hispanic/Latinx or non-Hispanic/Latinx. Charts without documented race (1001/24009, 4.2%) and ethnicity (387/24009, 1.6%) were excluded.

Results: Of 24009 delivery events, 323 were initially flagged as having a SMM. After chart review, 170 met criteria for study inclusion (0.7%). The most prevalent SMM was acute renal failure (n=87, 51.2%). A greater proportion of non-White and Hispanic/Latinx patients had a SMM when compared to the overall delivery population, but this was not statistically significant (P=0.12 and 0.08 respectively). Patients age > 35 were overrepresented in the SMM population (24.7% vs 17.5%, P=0.01). Non-English primary language was not a statistically significant factor associated with SMM (12.4% vs 11.1%, P=0.61).

Conclusion: Findings suggest minority (non-White, as well as Hispanic/Latinx) patients were not affected by SMM at a significantly higher rate at LVHN. Further study centered on other possible contributors to SMM (presence of chronic medical conditions, socioeconomic status, and history of SMM in prior pregnancy) is indicated in our population. Additionally, a lower than anticipated overall SMM rate could be attributed to using a modified transfusion variable.