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term.<\/jats:p><jats:p>Study Design\u2003We performed a secondary analysis of a multicenter observational study of 115,502 pregnant patients and their neonates (2008\u20132011). Singleton, nonanomalous pregnancies delivered from 37 to 41 weeks were included. Race and ethnicity were abstracted from the medical record and categorized as non-Hispanic White (White; referent), non-Hispanic Black (Black), non-Hispanic Asian (Asian), or Hispanic. The primary outcome was an adverse perinatal composite defined as perinatal death, Apgar score\u2009&lt;\u20094 at 5\u2009minutes, ventilator support, hypoxic\u2013ischemic encephalopathy, subgaleal hemorrhage, skeletal fracture, infant stay greater than maternal stay (by \u2265 3 days), brachial plexus palsy, or facial nerve palsy.<\/jats:p><jats:p>Results\u2003Of the 72,117 patients included, 48% were White, 20% Black, 5% Asian, and 26% Hispanic. The unadjusted risk of the primary outcome was highest for neonates of Black patients (3.1%, unadjusted relative risk [uRR]\u2009=\u20091.16, 95% confidence interval [CI]: 1.04\u20131.30), lowest for neonates of Hispanic patients (2.1%, uRR\u2009=\u20090.80, 95% CI: 0.71\u20130.89), and no different for neonates of Asian (2.6%), compared with those of White patients (2.7%). In the adjusted model including age, body mass index (BMI), smoking, obstetric history, and high-risk pregnancy, differences in risk for the primary outcome were no longer observed for neonates of Black (adjusted relative risk [aRR]\u2009=\u20091.06, 95% CI: 0.94\u20131.19) and Hispanic (aRR\u2009=\u20090.92, 95% CI: 0.81\u20131.04) patients. Adding insurance to the model lowered the risk for both groups (aRR\u2009=\u20090.85, 95% CI: 0.75\u20130.96 for Black; aRR\u2009=\u20090.68, 95% CI: 0.59\u20130.78 for Hispanic).<\/jats:p><jats:p>Conclusion\u2003Although neonates of Black patients have the highest frequency of adverse perinatal outcomes at term, after adjustment for sociodemographic factors, this higher risk is no longer observed, suggesting the importance of developing strategies that address social determinants of health to lessen extant health disparities.<\/jats:p><jats:p>Key Points<\/jats:p>","DOI":"10.1055\/s-0041-1730348","type":"journal-article","created":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T22:54:29Z","timestamp":1622501669000},"page":"557-566","source":"Crossref","is-referenced-by-count":13,"title":["Racial and Ethnic Disparities in Adverse Perinatal Outcomes at Term"],"prefix":"10.1055","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4795-3488","authenticated-orcid":false,"given":"Jacqueline G.","family":"Parchem","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, and Children's Memorial Hermann Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeline Murguia","family":"Rice","sequence":"additional","affiliation":[{"name":"George Washington University Biostatistics Center, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William A.","family":"Grobman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Bailit","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, MetroHealth Medical Center-Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald J.","family":"Wapner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle P.","family":"Debbink","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Thorp Jr","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve N.","family":"Caritis","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Prasad","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan T.N.","family":"Tita","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George R.","family":"Saade","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoram","family":"Sorokin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dwight J.","family":"Rouse","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Brown University, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9932-8908","authenticated-orcid":false,"given":"Jorge E.","family":"Tolosa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units (MFMU) 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