Objectives

To analyze healthcare resource utilization and severe maternal morbidity (SMM) in Black and White patients with preeclampsia diagnosis versus signs/symptoms.

Study design

This was a retrospective cohort study analyzing data from the IBM® Explorys Database between 7/31/2012–12/31/2020. Demographic, clinical, and laboratory data were extracted. Healthcare utilization and SMM were analyzed during the antepartum period (20 weeks of gestation until delivery) among Black and White patients with signs/symptoms of preeclampsia, with a diagnosis of preeclampsia, or neither (control).

Main outcome measures

Healthcare utilization and SMM in those with a preeclampsia diagnosis or signs/symptoms of preeclampsia only were compared with a control group (White patients with no preeclampsia diagnosis or signs/symptoms).

Results

Data from 38,190 Black and 248,568 White patients were analyzed. Patients with preeclampsia diagnosis or signs/symptoms were more likely to visit the emergency room compared to those without diagnosis or signs/symptoms. Black patients with signs/symptoms of preeclampsia had the highest elevated risk (odds ratio [OR] = 3.4), followed by Black patients with a preeclampsia diagnosis (OR = 3.2), White patients with signs/symptoms (OR = 2.2), and White patients with a preeclampsia diagnosis (OR = 1.8). More Black patients experienced SMM (SMM rate 6.1% [Black with preeclampsia diagnosis] and 2.6% [Black with signs/symptoms]) than White patients (5.0% [White with preeclampsia diagnosis] and 2.0% [White with signs/symptoms]). SMM rates were higher for Black preeclampsia patients with severe features than for White preeclampsia patients with severe features (8.9% vs 7.3%).

Conclusions

Compared with White patients, Black patients had higher rates of antepartum emergency care and antepartum SMM.

中文翻译：

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疑似或诊断为先兆子痫的患者在医疗保健利用方面的种族差异：一项回顾性队列研究

目标

分析诊断为先兆子痫的黑人和白人患者的医疗资源利用率和严重孕产妇发病率 (SMM) 与体征/症状。

学习规划

这是一项回顾性队列研究，分析了 2012 年 7 月 31 日至 2020 年 12 月 31 日期间 IBM® Explorys 数据库的数据。提取了人口统计、临床和实验室数据。对有先兆子痫体征/症状、诊断为先兆子痫或两者都没有（对照）的黑人和白人患者在产前期间（妊娠 20 周直至分娩）的医疗保健利用率和 SMM 进行了分析。

主要观察指标

将患有先兆子痫或仅出现先兆子痫体征/症状的患者的医疗保健利用率和 SMM 与对照组（没有先兆子痫诊断或体征/症状的白人患者）进行比较。

结果

分析了 38,190 名黑人和 248,568 名白人患者的数据。与没有诊断或没有体征/症状的患者相比，有先兆子痫诊断或体征/症状的患者更有可能去急诊室。有先兆子痫体征/症状的黑人患者风险升高最高（比值比 [OR] = 3.4），其次是被诊断为先兆子痫的黑人患者（OR = 3.2），有先兆子痫体征/症状的白人患者（OR = 2.2），以及诊断为先兆子痫的白人患者 (OR = 1.8)。经历 SMM 的黑人患者（SMM 率为 6.1% [患有先兆子痫诊断的黑人] 和 2.6% [患有先兆子痫的黑人]）比白人患者（5.0% [患有先兆子痫诊断的白人] 和 2.0% [患有先兆子痫的白人] 2.0%）更多。具有严重特征的黑人先兆子痫患者的 SMM 率高于具有严重特征的白人先兆子痫患者（8.9% vs 7.3%）。

结论

与白人患者相比，黑人患者的产前急救和产前 SMM 比例更高。