Racial and ethnic differences in transfusion rates in adolescent scoliosis surgery: Preoperative anemia as a mediator of disparity.

Background: Pediatric patients from minoritized racial and ethnic groups receive red blood cell (RBC) transfusions more frequently while undergoing major surgical procedures. Our objective was to identify the contribution of preoperative anemia to racial and ethnic differences in RBC transfusion rates in adolescent spine surgery.

Study Design And Methods: This is a multicenter, retrospective cohort study of the National Surgical Quality Improvement Program Pediatric database, 2016 to 2021 for patients in the United States and Canada.

Disparities in end-of-life care for minoritized racial and ethnic patients during terminal hospitalizations in New York State.

Background: Racial and ethnic minorities often receive care at different hospitals than non-Hispanic white patients, but how hospital characteristics influence the occurrence of disparities at the end of life is unknown. The aim of this study was to determine if disparities in end-of-life care were present among minoritized patients during terminal hospitalizations, and if these disparities varied with hospital characteristics.

Methods: We identified hospitalizations where a patient died in New York State, 2016-2018.

Racial and Ethnic Concordance Between the Patient and Anesthesia Team and Patients' Satisfaction With Pain Management During Cesarean Delivery.

Background: Racial and ethnic concordance between patients and health care providers increases patient satisfaction but has not been examined in obstetric anesthesia care. This study evaluated the association between racial and ethnic concordance and satisfaction with management of pain during cesarean delivery (PDCD).

Methods: This was a secondary analysis on a cohort of patients undergoing cesarean deliveries under neuraxial anesthesia that examined PDCD.

Structural Racism and Use of Labor Neuraxial Analgesia Among Non-Hispanic Black Birthing People.

Objective: To assess the association between structural racism and labor neuraxial analgesia use.

Methods: This cross-sectional study analyzed 2017 U.S.

State-Level Indicators of Structural Racism and Severe Adverse Maternal Outcomes During Childbirth.

Objectives: Structural racism (SR) is viewed as a root cause of racial and ethnic disparities in maternal health outcomes. However, evidence linking SR to increased odds of severe adverse maternal outcomes (SAMO) is scant. This study assessed the association between state-level indicators of SR and SAMO during childbirth.

Pain during cesarean delivery: A patient-related prospective observational study assessing the incidence and risk factors for intraoperative pain and intravenous medication administration.

Introduction: The incidence of pain during cesarean delivery (PDCD) remains unclear. Most studies evaluated PDCD using interventions suggesting inadequate analgesia: neuraxial replacement, unplanned intravenous medication (IVM), or conversion to general anesthesia. Few assess self-reported pain.

Delivery Outcomes and Postpartum Readmissions Associated with Ehlers-Danlos Syndrome.

Objective: Given that updated estimates of Ehlers-Danlos syndrome and risks for obstetric complications including postpartum readmission may be of public health significance, we sought to analyze associated obstetric trends and outcomes in a nationally representative population.

Study Design: The 2016 to 2020 Nationwide Readmissions Database was used for this retrospective cohort study. Delivery hospitalizations to women aged 15 to 54 with and without Ehlers-Danlos syndrome were identified.

Association of Labor Neuraxial Analgesia with Maternal Blood Transfusion.

Background: Labor neuraxial analgesia may reduce the odds of postpartum hemorrhage, the leading indication for maternal blood transfusion during childbirth. This study tested the hypothesis that labor neuraxial analgesia is associated with reduced odds of maternal blood transfusion overall.

Methods: U.

Medicaid expansion and risk of eclampsia.

Background: Eclampsia is an indicator of severe maternal morbidity and can be prevented through increased prenatal care access and early prenatal care utilization. The 2014 Medicaid expansion under the Patient Protection and Affordable Care Act allowed states to expand Medicaid coverage to nonelderly adults with incomes up to 138% of the federal poverty level. Its implementation has led to a significant increase in prenatal care access and utilization.

Association of the United States Affordable Care Act Dependent Coverage Provision with Labor Neuraxial Analgesia Use.

Background: Providing continuous health insurance coverage during the perinatal period may increase access to and utilization of labor neuraxial analgesia. This study tested the hypothesis that implementation of the 2010 Dependent Coverage Provision of the Patient Protection and Affordable Care Act, requiring private health insurers to allow young adults to remain on their parent's plan until age 26 yr, was associated with increased labor neuraxial analgesia use.

Methods: This study used a natural experiment design and birth certificate data for spontaneous vaginal deliveries in 28 U.

Nurse workforce diversity and reduced risk of severe adverse maternal outcomes.

Background: Racial and ethnic diversification of the physician and nurse workforce is recommended as a leverage point to address the impact of structural racism in maternal care, but empirical evidence supporting this recommendation is currently lacking.

Objective: This study aimed to assess the association between state-level registered nurse workforce racial and ethnic diversity and severe adverse maternal outcomes during childbirth.

Study Design: This population-based cross-sectional study analyzed 2017 US birth certificate data.

Health equity research in obstetric anesthesia.

Purpose Of Review: Health equity is an important priority for obstetric anesthesia, but describing disparities in perinatal care process and health outcome is insufficient to achieve this goal. Conceptualizing and framing disparity is a prerequisite to pose meaningful research questions. We emphasize the need to hypothesize and test which mechanisms and drivers are instrumental for disparities in perinatal processes and outcomes, in order to target, test and refine effective countermeasures.

Delivery outcomes associated with maternal congenital heart disease, 2000-2018.

Purpose: To characterize temporal trends and outcomes of delivery hospitalization with maternal congenital heart disease (CHD).

Materials And Methods: For this repeated cross-sectional analysis, deliveries to women aged 15-54 years with maternal CHD were identified in the 2000-2018 National Inpatient Sample. Temporal trends in maternal CHD were analyzed using joinpoint regression to estimate the average annual percentage change (AAPC) with 95% CIs.

Racial and Ethnic Disparities in the Management of Postdural Puncture Headache With Epidural Blood Patch for Obstetric Patients in New York State.

Importance: Characterizing and addressing racial and ethnic disparities in peripartum pain assessment and treatment is a national priority.

Objective: To evaluate the association of race and ethnicity with the provision and timing of an epidural blood patch (EBP) for management of postdural puncture headache in obstetric patients.

Design, Setting, And Participants: This cross-sectional study used New York State hospital discharge records from January 1, 1998, to December 31, 2016, from mothers 15 to 49 years of age with a postdural puncture headache after neuraxial analgesia or anesthesia for childbirth.

Use of Labor Neuraxial Analgesia for Vaginal Delivery and Severe Maternal Morbidity.

Importance: Addressing severe maternal morbidity (SMM) is a public health priority in the US. Use of labor neuraxial analgesia for vaginal delivery is suggested to reduce the risk of postpartum hemorrhage (PPH), the leading cause of preventable severe maternal morbidity.

Objective: To assess the association between the use of labor neuraxial analgesia for vaginal delivery and SMM.

Outcomes during delivery hospitalisations with inflammatory bowel disease.

Objective: To characterise inflammatory bowel disease (IBD) trends and associated risk during delivery hospitalisations.

Design: Cross-sectional.

Setting: US delivery hospitalisations.

Association of Medicaid Expansion Under the Affordable Care Act With Perinatal Care Access and Utilization Among Low-Income Women: A Systematic Review and Meta-analysis.

Objective: To synthesize the empirical research evidence about the association between Medicaid expansion under the Affordable Care Act (ACA) and increasing perinatal care access and utilization among low-income women.

Data Sources: We searched MEDLINE through PubMed (1966-present), EMBASE (Ovid), the Cumulative Index to Nursing and Allied Health (1982-present), PAIS Index (ProQuest), Web of Science (1900-present), and the Cochrane Central Register of Controlled Trials. Our review focuses on the association between Medicaid expansion under the ACA and perinatal care access and utilization, which cannot be subjected to randomized controlled trials, therefore ClinicalTrials.

Trends and outcomes for deliveries with hypertensive disorders of pregnancy from 2000 to 2018: A repeated cross-sectional study.

Objective: To analyse trends, risk factors, and outcomes related to hypertensive disorders of pregnancy (HDP).

Design: Repeated cross-sectional.

Setting: US delivery hospitalisations.

Trends in and Maternal Outcomes of Delivery Hospitalizations of Patients With an Asthma Diagnosis.

Objective: To characterize asthma prevalence and outcomes during U.S. delivery hospitalizations.

Utilization and Outcomes of Extracorporeal Membrane Oxygenation in Obstetric Patients in the United States, 1999-2014: A Retrospective Cross-Sectional Study.

Background: Utilization of extracorporeal membrane oxygenation (ECMO) for adult critically ill patients is increasing, but data in obstetric cohorts are scant. This study analyzed ECMO utilization and maternal outcomes in obstetric patients in the United States.

Methods: Data were abstracted from the 1999-2014 National Inpatient Sample (NIS), a 20% US national representative sample.