Preferred spoken language mediates differences in neuraxial labor analgesia utilization among racial and ethnic groups.
BACKGROUND
The aims of this study were to assess racial/ethnic disparities for neuraxial labor analgesia utilization and to determine if preferred spoken language mediates the association between race/ethnicity and neuraxial labor analgesia utilization.


METHODS
We performed a retrospective cohort study of 3129 obstetric patients who underwent vaginal delivery at a tertiary care obstetric center. Bivariate analyses and multivariate logistic regression models were used to assess the relationships between race/ethnicity, preferred spoken language and neuraxial labor analgesia.


RESULTS
Hispanic ethnicity (adjusted OR 0.77, 95% CI 0.61-0.98) and multiparity (adjusted OR 0.59, 95% CI 0.51-0.69) were independently associated with a reduced likelihood of neuraxial labor analgesia utilization. When preferred spoken language was controlled for, the effect of Hispanic ethnicity was no longer significant (adjusted OR 0.84, 95% CI 0.66-1.08) and only non-English preferred spoken language (adjusted OR 0.82, 95% CI 0.67-0.99) and multiparity (adjusted OR 0.59, 95% CI 0.51-0.69) were associated with a reduced likelihood of neuraxial labor analgesia utilization.


CONCLUSIONS
This study provides evidence that preferred spoken language mediates the relationship between Hispanic ethnicity and neuraxial labor analgesia utilization.
Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, USA.
J A
JA
Caballero
Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: ajbut@stanford.edu.
A J
AJ
Butwick
Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, USA.
B
B
Carvalho
Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, USA.
E T
ET
Riley
D000328:Adult; D001741:Black or African American; D016362:Analgesia, Obstetrical / Q000706:statistics & numerical data*; D001213:Asian; D036861:Delivery, Obstetric; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007802:Language; D057240:Patient Preference; D011247:Pregnancy; D044465:White People
Disparities; Ethnicity; Labor analgesia; Neuraxial analgesia; Race; Utilization