title: Equality in obstetrical care: racial/ethnic variation in group B streptococcus screening.
abstract: The objective of this article is to determine whether racial/ethnic disparities exist in screening for group B streptococcus (GBS) colonization among pregnant women. A retrospective cohort study of deliveries at a single institution was conducted. The primary outcome was the availability of GBS culture data at the time of delivery; the primary predictor was maternal race/ethnicity. Analyses were stratified by the time periods before and after the CDC recommendations for universal screening for GBS. Among 16,333 deliveries, 60.4% of the population was screened for GBS but screening rates varied markedly by year of delivery. Black women had a lower odds of having available GBS data (AOR 0.81 [0.69, 0.95]) but this disparity was limited to the period of time before universal screening was recommended. Prior to the recommendation for universal screening for GBS, racial/ethnic disparities existed in rates of screening among pregnant women delivering at term. These differences were reduced after 2002, suggesting that uniform policies regarding obstetrical care may be effective in eliminating disparities in obstetrical care and outcomes.
authors.affiliation: Department of Obstetrics and Gynecology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA. abryant@partners.org
authors.forename: Allison S
authors.initials: AS
authors.lastname: Bryant
authors.forename: Yvonne W
authors.initials: YW
authors.lastname: Cheng
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Caughey
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology*; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data; D009774:Obstetrics; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011787:Quality of Health Care; D012189:Retrospective Studies; D012495:San Francisco; D013290:Streptococcal Infections / Q000175:diagnosis*; D013292:Streptococcus agalactiae / Q000302:isolation & purification*; D055815:Young Adult