Racial/ethnic differences in pre-pregnancy conditions and adverse maternal outcomes in the nuMoM2b cohort: A population-based cohort study

• DOI: 10.1371/journal.pone.0306206
• Publication Date: 2024-08-12T17:26:06Z
• Authors: Meghan E. Meredith; Lauren N. Steimle; Kaitlyn K. Stanhope; Marissa H. Platner; Sheree L. Boulet
• Keywords: Adult; Science; Q; R; Pregnancy Outcome; 3. Good health; Cohort Studies; Pregnancy Complications; Young Adult; 03 medical and health sciences; 0302 clinical medicine; Pre-Eclampsia; Pregnancy; Risk Factors; Ethnicity; Medicine; Humans; Female; Research Article

Objectives To determine how pre-existing conditions contribute to racial disparities in adverse maternal outcomes and incorporate these into models improve risk prediction for minority subgroups. Study design We used data from the “Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b)" observational cohort study. defined multimorbidity as co-occurrence of two or more pre-pregnancy conditions. The primary interest were severe preeclampsia, postpartum readmission, blood transfusion during pregnancy up 14 days postpartum. weighted Poisson regression with robust variance estimate adjusted ratios 95% confidence intervals, we mediation analysis evaluate contribution combined effects racial/ethnic disparities. also evaluated predictive performance our by subgroup using area under receiver operating characteristic curve (AUC) metric. Results In nuMoM2b (n = 8729), accounting attenuated association between non-Hispanic Black race/ethnicity preeclampsia. Cardiovascular kidney associated preeclampsia among all women (aRR, 1.77; CI, 1.61–1.96, aRR, 1.27; 1.03–1.56 respectively). results not statistically significant; however, cardiovascular explained 36.6% (p 0.07). addition increased model Conclusions Pre-existing may explain some Specific incorporation comorbidities improved most models.