Torres Abigail, Ruiz Luis, Jepson Logan, Howell Megan, Carlson Alexandra, Stacey Joanna, Hammonds Kendall, Hofkamp Michael P
Texas A&M Health Science Center College of Medicine, Temple, Texas.
Department of Obstetrics and Gynecology, Baylor Scott & White Medical Center - Temple, Temple, Texas.
Proc (Bayl Univ Med Cent). 2022 Sep 13;36(1):30-33. doi: 10.1080/08998280.2022.2121106. eCollection 2023.
We hypothesized that racial disparities in labor epidural analgesia at our hospital that existed prior to the COVID-19 pandemic would be exacerbated during the COVID-19 pandemic. We examined patients who delivered vaginally at our hospital for the last 6 months of 2019 and the last 6 months of 2020. We performed joint testing of coefficient values, and the interaction term between race and year of delivery was not significant (0.364). A multivariate logistic regression model found that Hispanic patients (odds ratio 0.555 [0.408, 0.756], < 0.001) and Black or African American patients (odds ratio 0.613 [0.408, 0.921], = 0.018) were less likely to receive labor epidural analgesia compared to White or Caucasian patients. Odds ratios of receiving labor epidural analgesia were higher with increasing gestational age (1.116 [1.067, 1.168], < 0.001) and lower with increasing parity (0.789 [0.719, 0.867], < 0.001). The year of birth that corresponded to before or during the COVID-19 pandemic did not predict whether a patient received labor epidural analgesia (1.247 [0.941, 1.652], = 0.124). Because the interaction between race and year of birth was not statistically significant, we conclude that the COVID-19 pandemic did not exacerbate racial disparities in labor epidural analgesia at our hospital.
我们假设,在我们医院,新冠疫情大流行之前就存在的分娩硬膜外镇痛方面的种族差异,在新冠疫情大流行期间会加剧。我们研究了在2019年最后6个月和2020年最后6个月在我们医院经阴道分娩的患者。我们对系数值进行了联合检验,种族与分娩年份之间的交互项不显著(0.364)。多因素逻辑回归模型发现,与白人或高加索患者相比,西班牙裔患者(优势比0.555[0.408, 0.756],P<0.001)和黑人或非裔美国患者(优势比0.613[0.408, 0.921],P = 0.018)接受分娩硬膜外镇痛的可能性较小。随着孕周增加,接受分娩硬膜外镇痛的优势比更高(1.116[1.067, 1.168],P<0.001),随着产次增加,优势比更低(0.789[0.719, 0.867],P<0.001)。对应于新冠疫情大流行之前或期间的出生年份并不能预测患者是否接受分娩硬膜外镇痛(1.247[0.941, 1.652],P = 0.124)。由于种族与出生年份之间的交互作用无统计学意义,我们得出结论,新冠疫情大流行并未加剧我们医院分娩硬膜外镇痛方面的种族差异。
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