Does maternal asthma contribute to racial/ethnic disparities in obstetrical and neonatal complications?

Ann Epidemiol. 2015 Jun;25(6):392-397.e1. doi: 10.1016/j.annepidem.2015.01.011. Epub 2015 Jan 30.

Abstract

Purpose: To examine whether maternal asthma contributes to racial/ethnic differences in obstetrical and neonatal complications.

Methods: Data on white (n = 110,603), black (n = 50,284), and Hispanic (n = 38,831) singleton deliveries came from the Consortium on Safe Labor. Multilevel logistic regression models, with an interaction term for asthma and race/ethnicity, estimated within-group adjusted odds ratios (aORs) for gestational diabetes, gestational hypertension, pre-eclampsia, placental abruption, premature rupture of membranes, preterm delivery, maternal hemorrhage, neonatal intensive care unit admissions, small for gestational age, apnea, respiratory distress syndrome, transient tachypnea of the newborn, anemia, and hyperbilirubinemia after adjustment for clinical and demographic confounders. Nonasthmatics of the same racial/ethnic group were the reference group.

Results: Compared with nonasthmatics, white asthmatics had increased odds of pre-eclampsia (aOR, 1.28; 95% confidence interval [CI], 1.15-1.43) and maternal hemorrhage (aOR, 1.14; 95% CI, 1.04-1.23). White and Hispanic infants were more likely to have neonatal intensive care unit admissions (aOR, 1.19; 95% CI, 1.11-1.28; aOR, 1.16; 95% CI, 1.02-1.32, respectively) and be small for gestational age (aOR, 1.11; 95% CI, 1.02-1.20; aOR, 1.26; 95% CI, 1.10-1.44, respectively), and Hispanic infants were more likely to have apnea (aOR, 1.32; 95% CI, 1.02-1.69).

Conclusions: Maternal asthma did not affect most obstetrical and neonatal complication risks within racial/ethnic groups. Despite their increased risk for both asthma and many complications, our findings for black women were null. Asthma did not contribute to racial/ethnic disparities in complications.

Keywords: Asthma; Ethnic groups; Health disparities; Infant; Pregnancy.

Publication types

  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abruptio Placentae / ethnology
  • Adult
  • Apnea / ethnology
  • Asthma / complications
  • Asthma / ethnology*
  • Black People
  • Delivery, Obstetric
  • Diabetes, Gestational / ethnology
  • Ethnicity
  • Female
  • Fetal Membranes, Premature Rupture / ethnology
  • Health Status Disparities*
  • Hispanic or Latino
  • Humans
  • Hyperbilirubinemia / ethnology
  • Infant, Newborn
  • Infant, Newborn, Diseases / ethnology*
  • Infant, Small for Gestational Age
  • Postpartum Hemorrhage / ethnology
  • Pre-Eclampsia / ethnology
  • Pregnancy
  • Pregnancy Complications / ethnology*
  • Premature Birth / ethnology
  • Respiratory Distress Syndrome, Newborn / ethnology
  • Retrospective Studies
  • Tachypnea / ethnology
  • United States
  • White People
  • Young Adult