Racial differences in asthma morbidity during pregnancy.
OBJECTIVE
Little is known about racial differences in asthma outcomes during pregnancy. We performed a cohort study to estimate racial differences in maternal asthma outcomes in a low-income population of pregnant women in which blacks and whites have similar medical care access and benefits.


METHODS
We conducted a population-based cohort study of asthma-related morbidity in black and white pregnant women enrolled in Tennessee's Medicaid Program, TennCare. Pregnant women were identified through TennCare enrollment files linked to birth certificates, 1995-2001. Prepregnancy, women with asthma were identified using International Classification of Diseases, 9th Revision, codes for health care visits and pharmacy files for asthma medication. Adjusted relative rates (RR) of rescue corticosteroid prescriptions, emergency department (ED) visits, and hospitalizations during pregnancy were compared by race using Poisson regression.


RESULTS
We identified 4,315 women with asthma (4%) from a population of 112,171 pregnant women of black or white race with at least 180 days of continuous enrollment in TennCare before pregnancy. Blacks were more likely to receive a course of rescue corticosteroids than whites (14.6% versus 11.9%, adjusted RR 1.35, 95% confidence interval [CI] 1.14-1.61), have an emergency department visit (16.7% versus 8.7%, adjusted RR 1.89, 95% CI 1.57-2.27), or be hospitalized for asthma (9.0% versus 5.2%, adjusted RR 1.73, 95% CI 1.34-2.24).


CONCLUSIONS
Pregnant women with asthma had high asthma-related morbidity. Black women had clinically significantly more morbidity than whites. There is a need to improve the medical care of low-income women with asthma, particularly black women.


METHODS
II-2.
Vanderbilt University School of Medicine, Department of Pediatrics, Nashville, TN 37232, USA.
Kecia N
KN
Carroll
Marie R
MR
Griffin
Tebeb
T
Gebretsadik
Ayumi
A
Shintani
Ed
E
Mitchel
Tina V
TV
Hartert
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D017677:Age Distribution; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy / Q000208:ethnology*; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008423:Maternal Age; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000208:ethnology; D011256:Pregnancy Outcome; D011295:Prenatal Care; D018570:Risk Assessment; D012720:Severity of Illness Index; D013714:Tennessee / Q000453:epidemiology; D016896:Treatment Outcome; D044465:White People / Q000706:statistics & numerical data*
D018927:Anti-Asthmatic Agents