Katz Daniel, Khadge Shradha, Carvalho Brendan
Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, USA.
Anesthesiology, Perioperative and Pain Medicine, Stanford University Medical Center, Stanford, USA.
Cureus. 2022 May 24;14(5):e25299. doi: 10.7759/cureus.25299. eCollection 2022 May.
Racial and ethnic disparities in peripartum blood loss and postpartum hemorrhage (PPH) have not been adequately evaluated. We sought to compare postpartum blood loss and PPH in African American and Hispanic parturients compared to other groups.
This was a secondary analysis of an observational study at a tertiary academic center of a historical (August 2016 to January 2017) and interventional (August 2017 to January 2018) cohort of 7618 deliveries. Visual estimation of blood loss (EBL) was used in the historical group and quantitative blood loss (QBL) was implemented in the intervention group. Our primary endpoint was median blood loss in African Americans versus other racial groups between cohorts.
A total of 7618 deliveries were evaluated; 755 (9.9%) were identified as African American with 1035 (13.6%) identifying as Hispanic. Blood loss was similar in racial groups using EBL (p=0.131), but not QBL that was 430 (227-771) in African Americans and 348 (200-612) in non-African Americans (p<0.001). PPH was greater among African Americans in both groups (10.3% vs. 6.9% in EBL cohort, p=0.023, and 16.9% vs. 11.6% in QBL cohort, p<0.001).
Racial and ethnic differences in peripartum blood loss were more apparent with QBL than EBL. It is unknown if these differences are caused by provider cognitive bias, socioeconomic differences, language barriers and/or other factors.
围产期失血和产后出血（PPH）方面的种族和民族差异尚未得到充分评估。我们试图比较非裔美国人和西班牙裔产妇与其他群体的产后失血量和PPH情况。
这是对一家三级学术中心的一项观察性研究的二次分析，该研究涉及一个历史队列（2016年8月至2017年1月）和一个干预队列（2017年8月至2018年1月），共有7618例分娩。历史队列采用目测失血量（EBL），干预队列采用定量失血量（QBL）。我们的主要终点是各队列中非裔美国人与其他种族群体的中位失血量。
共评估了7618例分娩；其中755例（9.9%）被确定为非裔美国人，1035例（13.6%）被确定为西班牙裔。使用EBL时，各种族群体的失血量相似（p=0.131），但使用QBL时不同，非裔美国人的失血量为430（227 - 771），非非裔美国人的失血量为348（200 - 612）（p<0.001）。两组中，非裔美国人的PPH发生率均更高（EBL队列中为10.3%对6.9%，p=0.023；QBL队列中为16.9%对11.6%，p<0.001）。
与EBL相比，QBL更能体现围产期失血的种族和民族差异。尚不清楚这些差异是由医疗服务提供者的认知偏差、社会经济差异、语言障碍和/或其他因素引起的。
