Does maternal asthma contribute to racial/ethnic disparities in obstetrical and neonatal complications?
OBJECTIVE
To examine whether maternal asthma contributes to racial/ethnic differences in obstetrical and neonatal complications.


METHODS
Data on white (n = 110,603), black (n = 50,284), and Hispanic (n = 38,831) singleton deliveries came from the Consortium on Safe Labor. Multilevel logistic regression models, with an interaction term for asthma and race/ethnicity, estimated within-group adjusted odds ratios (aORs) for gestational diabetes, gestational hypertension, pre-eclampsia, placental abruption, premature rupture of membranes, preterm delivery, maternal hemorrhage, neonatal intensive care unit admissions, small for gestational age, apnea, respiratory distress syndrome, transient tachypnea of the newborn, anemia, and hyperbilirubinemia after adjustment for clinical and demographic confounders. Nonasthmatics of the same racial/ethnic group were the reference group.


RESULTS
Compared with nonasthmatics, white asthmatics had increased odds of pre-eclampsia (aOR, 1.28; 95% confidence interval [CI], 1.15-1.43) and maternal hemorrhage (aOR, 1.14; 95% CI, 1.04-1.23). White and Hispanic infants were more likely to have neonatal intensive care unit admissions (aOR, 1.19; 95% CI, 1.11-1.28; aOR, 1.16; 95% CI, 1.02-1.32, respectively) and be small for gestational age (aOR, 1.11; 95% CI, 1.02-1.20; aOR, 1.26; 95% CI, 1.10-1.44, respectively), and Hispanic infants were more likely to have apnea (aOR, 1.32; 95% CI, 1.02-1.69).


CONCLUSIONS
Maternal asthma did not affect most obstetrical and neonatal complication risks within racial/ethnic groups. Despite their increased risk for both asthma and many complications, our findings for black women were null. Asthma did not contribute to racial/ethnic disparities in complications.
Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MD.
Katrina F
KF
Flores
Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MD.
Candace A
CA
Robledo
Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MD.
Beom Seuk
BS
Hwang
Division of Epidemiology, Office of Surveillance and Epidemiology, Office of Pharmacovigilance and Epidemiology, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD.
Kira
K
Leishear
Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MD.
Katherine
K
Laughon Grantz
Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MD. Electronic address: pauline.mendola@nih.gov.
Pauline
P
Mendola
D000037:Abruptio Placentae / Q000208:ethnology; D000328:Adult; D001049:Apnea / Q000208:ethnology; D001249:Asthma / Q000150:complications / Q000208:ethnology*; D044383:Black People; D036861:Delivery, Obstetric; D016640:Diabetes, Gestational / Q000208:ethnology; D005006:Ethnicity; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000208:ethnology; D054624:Health Status Disparities; D006630:Hispanic or Latino; D006801:Humans; D006932:Hyperbilirubinemia / Q000208:ethnology; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000208:ethnology*; D007236:Infant, Small for Gestational Age; D006473:Postpartum Hemorrhage / Q000208:ethnology; D011225:Pre-Eclampsia / Q000208:ethnology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology*; D047928:Premature Birth / Q000208:ethnology; D012127:Respiratory Distress Syndrome, Newborn / Q000208:ethnology; D012189:Retrospective Studies; D059246:Tachypnea / Q000208:ethnology; D014481:United States; D044465:White People; D055815:Young Adult; D001741:Black or African American
Asthma; Ethnic groups; Health disparities; Infant; Pregnancy