TY - JOUR
T1 - Racial/Ethnic Differences in Labor Outcomes with Prostaglandin Vaginal Inserts
AU - Stephenson, Megan L.
AU - Hawkins, J. Seth
AU - Pevzner, Leo
AU - Powers, Barbara L.
AU - Wing, Deborah A.
N1 - Funding Information:
This research was funded by Controlled Therapeutics (Scotland) Ltd, wholly owned subsidiary of Cytokine PharmaSciences, Inc. In 2012, Ferring Pharmaceuticals, Inc. acquired Cytokine PharmaSciences, Inc. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 []. Informed consent was obtained from all patients for being included in the study.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - OBJECTIVE: The aim of this study is to compare labor outcomes across race/ethnicity in women undergoing prostaglandin labor induction.METHODS: Secondary analysis of misoprostol vaginal insert (MVI) trial, a double-blind, randomized, control trial of 1,308 patients comparing sustained release vaginal inserts containing dinoprostone 10 mg and misoprostol 50 mcg (MVI 50) or 100 mcg (MVI 100).RESULTS: Achievement of active labor and induction failures were similar across race/ethnicity. Cesareans were performed less frequently in whites (29 %) and Hispanics (24.5 %) compared to blacks (32.7 %) (adjusted odds ratio (aOR) 0.87, 95 % confidence interval (CI) 0.47-0.97, p = 0.03 and aOR 0.86, 95 % CI 0.44-0.97, p = 0.03, respectively). When compared to blacks, whites were less likely to undergo cesarean for non-reassuring fetal heart rate tracing (aOR 0.41, 95 % CI 0.25-0.66, p = 0.0003), as were Hispanics (aOR 0.38, 95 % CI 0.22-0.65, p = 0.0004). Postpartum hemorrhage occurred more frequently in Hispanics (8.8 %) versus blacks (4.1 %) and whites (OR 2.27, 95 % CI 0.23-0.82, p = 0.02 and OR 3.69, 95 % CI 0.14-0.51, p < 0.0001, respectively). Birth weights of black infants were lower than whites (p < 0.0001) and Hispanics (p = 0.0003). Neonatal outcomes did not differ between groups.CONCLUSION: Differences in labor induction outcomes with prostaglandin labor induction exist based on race/ethnicity. Blacks delivered smaller babies, were more likely to undergo cesarean, and have cesareans performed for non-reassuring fetal heart tracing compared to other groups. Hispanics were more likely to experience postpartum hemorrhage compared to the other races.
AB - OBJECTIVE: The aim of this study is to compare labor outcomes across race/ethnicity in women undergoing prostaglandin labor induction.METHODS: Secondary analysis of misoprostol vaginal insert (MVI) trial, a double-blind, randomized, control trial of 1,308 patients comparing sustained release vaginal inserts containing dinoprostone 10 mg and misoprostol 50 mcg (MVI 50) or 100 mcg (MVI 100).RESULTS: Achievement of active labor and induction failures were similar across race/ethnicity. Cesareans were performed less frequently in whites (29 %) and Hispanics (24.5 %) compared to blacks (32.7 %) (adjusted odds ratio (aOR) 0.87, 95 % confidence interval (CI) 0.47-0.97, p = 0.03 and aOR 0.86, 95 % CI 0.44-0.97, p = 0.03, respectively). When compared to blacks, whites were less likely to undergo cesarean for non-reassuring fetal heart rate tracing (aOR 0.41, 95 % CI 0.25-0.66, p = 0.0003), as were Hispanics (aOR 0.38, 95 % CI 0.22-0.65, p = 0.0004). Postpartum hemorrhage occurred more frequently in Hispanics (8.8 %) versus blacks (4.1 %) and whites (OR 2.27, 95 % CI 0.23-0.82, p = 0.02 and OR 3.69, 95 % CI 0.14-0.51, p < 0.0001, respectively). Birth weights of black infants were lower than whites (p < 0.0001) and Hispanics (p = 0.0003). Neonatal outcomes did not differ between groups.CONCLUSION: Differences in labor induction outcomes with prostaglandin labor induction exist based on race/ethnicity. Blacks delivered smaller babies, were more likely to undergo cesarean, and have cesareans performed for non-reassuring fetal heart tracing compared to other groups. Hispanics were more likely to experience postpartum hemorrhage compared to the other races.
KW - Cesarean
KW - Disparity
KW - Labor induction
KW - Race
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U2 - 10.1007/s40615-014-0058-7
DO - 10.1007/s40615-014-0058-7
M3 - Article
C2 - 26863333
AN - SCOPUS:84987942249
SN - 2197-3792
VL - 2
SP - 149
EP - 157
JO - Journal of Racial and Ethnic Health Disparities
JF - Journal of Racial and Ethnic Health Disparities
IS - 2
ER -