Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California Irvine Medical Center, Orange, CA, 92868, USA.
Department of Obstetrics and Gynecology, Memorial Care Center for Women at Miller Children's Hospital, Long Beach Memorial Medical Center, Long Beach, CA, 90806, USA.
J Racial Ethn Health Disparities. 2015 Jun;2(2):149-57. doi: 10.1007/s40615-014-0058-7. Epub 2014 Oct 2.
The aim of this study is to compare labor outcomes across race/ethnicity in women undergoing prostaglandin labor induction.
Secondary analysis of misoprostol vaginal insert (MVI) trial, a double-blind, randomized, control trial of 1,308 patients comparing sustained release vaginal inserts containing dinoprostone 10 mg and misoprostol 50 mcg (MVI 50) or 100 mcg (MVI 100).
Achievement of active labor and induction failures were similar across race/ethnicity. Cesareans were performed less frequently in whites (29 %) and Hispanics (24.5 %) compared to blacks (32.7 %) (adjusted odds ratio (aOR) 0.87, 95 % confidence interval (CI) 0.47-0.97, p = 0.03 and aOR 0.86, 95 % CI 0.44-0.97, p = 0.03, respectively). When compared to blacks, whites were less likely to undergo cesarean for non-reassuring fetal heart rate tracing (aOR 0.41, 95 % CI 0.25-0.66, p = 0.0003), as were Hispanics (aOR 0.38, 95 % CI 0.22-0.65, p = 0.0004). Postpartum hemorrhage occurred more frequently in Hispanics (8.8 %) versus blacks (4.1 %) and whites (OR 2.27, 95 % CI 0.23-0.82, p = 0.02 and OR 3.69, 95 % CI 0.14-0.51, p < 0.0001, respectively). Birth weights of black infants were lower than whites (p < 0.0001) and Hispanics (p = 0.0003). Neonatal outcomes did not differ between groups.
Differences in labor induction outcomes with prostaglandin labor induction exist based on race/ethnicity. Blacks delivered smaller babies, were more likely to undergo cesarean, and have cesareans performed for non-reassuring fetal heart tracing compared to other groups. Hispanics were more likely to experience postpartum hemorrhage compared to the other races.
本研究旨在比较行前列腺素引产的不同种族/族裔妇女的分娩结局。
对米索前列醇阴道栓剂（MVI）试验进行二次分析，这是一项双盲、随机对照试验，共纳入 1308 例患者，比较含有地诺前列酮 10mg 和米索前列醇 50μg（MVI 50）或 100μg（MVI 100）的持续释放阴道栓剂的效果。
不同种族/族裔之间，活跃分娩的实现和引产失败的发生率相似。与黑人（32.7%）相比，白人（29%）和西班牙裔（24.5%）剖宫产的发生率较低（调整后的优势比（aOR）0.87，95%置信区间（CI）0.47-0.97，p=0.03 和 aOR 0.86，95%CI 0.44-0.97，p=0.03）。与黑人相比，白人因胎心监护图不令人满意而行剖宫产的可能性较小（aOR 0.41，95%CI 0.25-0.66，p=0.0003），西班牙裔也是如此（aOR 0.38，95%CI 0.22-0.65，p=0.0004）。与黑人（4.1%）和白人（8.8%）相比，西班牙裔产后出血的发生率更高（OR 2.27，95%CI 0.23-0.82，p=0.02 和 OR 3.69，95%CI 0.14-0.51，p<0.0001）。黑人婴儿的出生体重低于白人（p<0.0001）和西班牙裔（p=0.0003）。各组间新生儿结局无差异。
基于种族/族裔，前列腺素引产的分娩结局存在差异。与其他组相比，黑人分娩的婴儿较小，更有可能行剖宫产，且因胎心监护图不令人满意而行剖宫产的比例更高。与其他种族相比，西班牙裔更有可能出现产后出血。
