(306) Impact of race/ethnicity on pregnancy outcomes in expectant management of severe hypertensive disorders of pregnancy

This is a prospective multi-center cohort study between November 2019 and March 2022, including singleton pregnancies from 23 to 31 weeks’ gestation who were diagnosed with a severe hypertensive disorder of pregnancy and managed expectantly beyond 48 hours. Diagnosis and management of the HDP was at the discretion of the admitting provider. Race/ethnicity was determined by self-report. The primary outcome was a composite maternal morbidity including indicators of worsening hypertensive disease. A composite neonatal morbidity was also evaluated. Data were analyzed with use of fisher’s exact test and ANOVA as appropriate.

Results:

A cohort of 90 patients who met the inclusion criteria were identified. We found 42 (47%) patients identified as White, 31 (34%) Black, 11 (12%) Hispanic and 6 (7%) “Other”. Mode of delivery and gestational age at delivery were similar between the groups. Latency between admission and time of delivery was significantly longer in patients who identified as Black (20.9 days vs 8.8 to 9.3 days, p = 0.005). There were no significant differences in the primary composite outcome, which was present in 9 (26%) of the White group and 4 (14%) of the Black group, and did not occur in the Hispanic or “Other” groups. No significant differences in composite neonatal morbidity were identified.

Conclusion:

We found a significantly longer latency period between admission and delivery in patients who identified as Black, without an increase in adverse outcome of expectantly managed patients with severe HDP. In addition, race/ethnicity did not increase the composite outcome of maternal morbidity or neonatal morbidity. More studies are warranted in order to evaluate the discrepant latency period between the different race/ethnicity groups.