Abstract Number: PB1297
Meeting: ISTH 2021 Congress
Background: Postpartum hemorrhage (PPH) is a prevalent cause of maternal morbidity and mortality in the United States. Non-Hispanic Black patients experience higher rates of PPH, as well as greater prevalence of anemia in pregnancy (AIP), a known risk factor for PPH.
Aims: To describe the racial distribution of AIP across three nationwide datasets, and to determine the peripartum transfusion rate and characteristics of transfusion recipients, to better understand disparities in hemostatic outcomes.
Methods: Using Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal Fetal Medicine Units Network Cesarean Registry (CR), NICHD Consortium on Safe Labor Registry (CSL), and a cohort of deliveries at Universal Health Services (UHS) hospitals, univariable associations were described between race, anemia and transfusion. Multivariable logistic regressions examined associations of race with transfusion, independent of anemia, and of anemia with transfusion, independent of race. Multivariable models included covariates: age, parity, smoking during pregnancy, BMI, and delivery mode. The anemia by race interaction was also investigated.
Results: We included n=56,964 from CR, 140,324 from CSL, 87,465 from UHS (with 28%, 24%, 12% Black respectively). Prevalence of anemia was 8% in CR, 13% in CSL, 7% in UHS. Anemia was more common in Black patients (CR OR 2.52 [95%CI 2.37-2.68], CSL OR 1.48 [95%CI 1.43-1.53], UHS OR 2.61 [95%CI 2.45-2.79]) and was universally associated with transfusion (OR 6.46 [5.78-7.22], OR 1.27 [1.18-1.37], OR 5.79 [4.58-7.32], respectively). After adjusting for covariates, Black patients were more likely to receive blood transfusions in CR (aOR 1.32 [1.16-1.50, p<.0001]), but not in UHS or CSL (aORs 1.19 [0.89-1.59, p=.24], 0.40 [0.36-0.44, p<.0001] respectively).
Conclusions: Although anemia was more common among Black patients, the relationship between race and transfusion differed between databases, suggesting other unexplored factors are involved.
To cite this abstract in AMA style:Davis E, Amdur R, Ahmadzia H. Interactions of Anemia with Race and Peripartum Transfusion in Three Large US Registries [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/interactions-of-anemia-with-race-and-peripartum-transfusion-in-three-large-us-registries/. Accessed August 19, 2022.
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