43 - Prospective Survey of Discrimination in Pregnant Persons and Correlation with Unplanned Healthcare Utilization

Friday, February 10, 2023

1:45 PM – 2:00 PM

Location: Room 3009, Moscone West, Level 3

Objective: To determine the association between lifetime exposure to discrimination and unplanned healthcare utilization in pregnant persons.

Study Design: This was a prospective cohort study of pregnant persons receiving care at a single Midwestern academic institution from 2021 to 2022. Primary data was collected from participants on sociodemographic factors and on Perceived Ethnic and Discrimination Questionnaire (PED-Q), a validated 17-item scale measuring perceived lifetime interpersonal racial and ethnic discrimination in four domains: work/school, social exclusion, stigmatization, and threat. The primary outcome was unplanned healthcare utilization, defined as unplanned labor and delivery admissions, triage, Emergency Department, or urgent care visits. Bivariate and multivariate analyses were done to examine the association between lifetime exposure to discrimination and unplanned healthcare utilization.

Results: A total of 289 completed the PED-Q and were included in the analysis. Of these, 123 (42.6%) had unplanned healthcare utilization. Median [interquartile range] of lifetime discrimination was higher in the unplanned healthcare utilization group (1.6 [1.2, 1.9] vs. 1.4 [1.1-1.8], p=0.017) (Table 1). Univariate analysis showed that lifetime discrimination was significantly associated with unplanned healthcare utilization (OR 1.96, 95% CI 0.23-3.11). Significant associations were found between unplanned healthcare utilization and maternal age (p=0.04), insurance type (p=0.01), married status (p < 0.001), education (p=0.013), household income (p=0.001), and chronic hypertension (p=0.004). After controlling for potential confounding factors (Table 2), perceived lifetime discrimination remained significantly associated with higher odds of unplanned healthcare utilization (aOR 1.78, CI 95% 1.01-3.11). Factors that remained associated with unplanned healthcare utilization were maternal age, chronic hypertension, and number of prior pregnancies.

Conclusion: We found that a higher level of perceived lifetime discrimination was associated with increased unplanned healthcare utilization during pregnancy.

Primary & Presenting Author(s)

Rachel Greenberg, BS (she/her/hers)

Medical Student
Medical College of Wisconsin
Wauwatosa, Wisconsin, United States

Coauthor(s)

Ronald Anguzu, MPH, PhD

Assistant Professor
Medical College of Wisconsin
Milwaukee, WI, United States
Elisha Jaeke, BS (she/her/hers)

Medical Student
Medical College of Wisconsin
Wauwatosa, Wisconsin, United States
Anna Palatnik, MD

Medical College of Wisconsin
Milwaukee, Wisconsin, United States