Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Maternal Outcomes by Race in Women Aged ≥40 Years

Obstet Gynecol; ePub 2018 Jul 10; Booker, et al

Black women aged ≥40 years are at increased relative risk for severe maternal morbidity and are at even higher risk for mortality, a recent study found. The retrospective cohort study used the Nationwide Inpatient Sample for the years 1998-2014. Women aged 40-54 years were included. Race and ethnicity were categorized as non-Hispanic white, non-Hispanic black, Hispanic, Asian, or Pacific Islander, Native American, other, or unknown. Among the findings:

  • A total of 1,724,694 deliveries were included in the analysis.
  • Severe maternal morbidity increased over the study period from 1.6% in 1998-2000 to 3.0% from 2013 to 2014.
  • Black women had the highest rates of severe morbidity at both the beginning and end of the study.
  • Pregnancy complications including preeclampsia, cesarean delivery, and gestational diabetes were more common at the end compared with the beginning of the study for black, white, and Hispanic women.
  • The adjusted risk ratio for overall severe morbidity for black women (RR 4.71) and Hispanic women had more than twice the risk of death (RR 2.13) as white women.


Booker WA, Gyamfi-Bannerman C, Sheen J-J, et al. Maternal outcomes by race for women aged 40 years or older. [Published online ahead of print July 10, 2018]. Obstet Gynecol. doi:10.1097/AOG.0000000000002751.

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