Racial and ethnic disparities in NTSV rates among universally insured military patients

To evaluate racial/ethnic disparities in the cesarean birth rate among NTSV pregnancies at a single tertiary Naval hospital with universal healthcare. This is a retrospective cohort study including 5,625 NTSV pregnancies between 2015 - 2019. Women were grouped as non-Hispanic white, non-Hispanic black, Hispanic/Latino, Asian and Pacific Islander, and other. Multivariable logistic regression models were used to evaluate associations between race/ethnicity and cesarean birth rates and indication for cesarean birth. Non-Hispanic black women are more likely to undergo cesarean birth compared to non-Hispanic white women among NTSV pregnancies (OR 1.60, CI 1.38 – 1.85, P < 0.001) despite controlling for patient characteristics including socioeconomic status and comorbidities (aOR 1.69, CI 1.43 – 1.99, P < 0.001). Furthermore, these women are more likely to undergo cesarean for non-reassuring fetal heart tracing compared to non-Hispanic white women (60.1% compared to 42.3%, respectively). No other racial/ethnic minority was noted to have a significantly different NTSV cesarean birth rate compared to non-Hispanic white women. Patient characteristics and comorbidities do not account for the observed increase in NTSV cesarean birth rates among non-Hispanic black women, which is largely accounted for by cesarean births for non-reassuring fetal heart tracings.View Large Image Figure ViewerDownload Hi-res image Download (PPT)