Racial, ethnic, and economic disparities in the prevalence of pregnancy complications

Abstract

Objectives: Our objective was to use maternal self-reported data to estimate the prevalence of urinary tract infections, placenta disorders, and preterm rupture of the membranes (PROM) and to explore the association between these complications and race, ethnicity, and economic status.

Methods: We used data for the years 2000-2002 from the Pregnancy Risk Assessment Monitoring System (PRAMS), an ongoing survey of women with a recent live birth, to examine the prevalence of and hospitalizations for self-reported urinary tract infections, placenta disorders, and PROM and to investigate differences by maternal race, Hispanic ethnicity, and economic status. Prevalence and hospitalizations were calculated as a percent of the represented population using SUDAAN to account for the sampling design.

Results: Urinary tract infections were commonly reported, occurring in more than 17% of women during their pregnancy. Placenta disorders and PROM were each reported by approximately 6% of women. Poverty and race had independent effects on each of the pregnancy complications examined. Fewer than half of the women who experienced these pregnancy complications were hospitalized.

Conclusions: Pregnancy complications are common and not adequately measured by hospitalizations alone. Both more research and improved surveillance are needed to understand the effect of pregnancy complications on women's health and the reasons for the increased risk among poor or black women.