Singh Jasbir, Reddy Uma M, Huang Chun-Chih, Driggers Rita W, Landy Helain J, Grantz Katherine L
Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia.
MedStar Health Research Institute, Hyattsville, Maryland.
Am J Perinatol. 2018 Mar;35(4):361-368. doi: 10.1055/s-0037-1607285. Epub 2017 Oct 24.
To examine labor induction by race/ethnicity and factors associated with disparity in induction.
This is a retrospective cohort study of 143,634 women eligible for induction ≥24 weeks' gestation from 12 clinical centers (2002-2008). Rates of labor induction for each racial/ethnic group were calculated and stratified by gestational age intervals: early preterm (24-33), late preterm (34-36), and term (37-41 weeks). Multivariable logistic regression examined the association between maternal race/ethnicity and induction controlling for maternal characteristics and pregnancy complications. The primary outcome was rate of induction by race/ethnicity. Inductions that were indicated, non-medically indicated, or without recorded indication were also compared.
Non-Hispanic black (NHB) women had the highest percentage rate of induction, 44.6% ( < 0.001). After adjustment, all racial/ethnic groups had lower odds of induction compared with non-Hispanic white (NHW) women. At term, NHW women had the highest percentage rate (45.4%) of non-medically indicated or induction with no indication ( < 0.001).
Compared with other racial/ethnic groups, NHW women were more likely to undergo non-medically indicated induction at term. As labor induction may avoid the occurrence of stillbirth, whether this finding explains part of the increased risk of stillbirth for NHB women at term merits further research.
按种族/族裔研究引产情况以及与引产差异相关的因素。
这是一项对来自12个临床中心（2002 - 2008年）的143634名妊娠≥24周且符合引产条件的女性进行的回顾性队列研究。计算每个种族/族裔组的引产率，并按孕周区间分层：极早早产（24 - 33周）、晚期早产（34 - 36周）和足月（37 - 41周）。多变量逻辑回归分析在控制产妇特征和妊娠并发症的情况下，研究产妇种族/族裔与引产之间的关联。主要结局是按种族/族裔划分的引产率。还对有指征引产、非医学指征引产或无记录指征引产的情况进行了比较。
非西班牙裔黑人（NHB）女性的引产率最高，为44.6%（P < 0.001）。调整后，与非西班牙裔白人（NHW）女性相比，所有种族/族裔组引产的几率均较低。在足月时，NHW女性非医学指征引产或无指征引产的比例最高（45.4%）（P < 0.001）。
与其他种族/族裔组相比，NHW女性在足月时更有可能接受非医学指征引产。由于引产可能避免死产的发生，这一发现是否解释了NHB女性足月时死产风险增加的部分原因值得进一步研究。
