{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T22:58:21Z","timestamp":1782514701174,"version":"3.54.5"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"14","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:p>\n            Objective\u2003Maternal race and ethnicity have been identified as significant independent predictors of obstetric morbidity and mortality in the United States. An appreciation of the clinical contexts in which maternal racial and ethnic disparities are most pronounced can better target efforts to alleviate these disparities and improve outcomes. It remains unknown whether cesarean delivery precipitates these divergent outcomes. This study assessed the association between maternal race and ethnicity and cesarean complications.<\/jats:p><jats:p>\n            Study Design\u2003We conducted a retrospective cohort study from a multicenter observational cohort of women undergoing cesarean delivery. Nulliparous women with non-anomalous singleton gestations who underwent primary cesarean section were included. Race\/ethnicity was categorized as non-Hispanic White, non-Hispanic Black, Hispanic, Asian, Native American, or unknown. The primary outcome was a composite of maternal cesarean complications including hysterectomy, uterine atony, blood transfusion, surgical injury, arterial ligation, infection, wound complication, and ileus. A composite of neonatal morbidity was evaluated as a secondary outcome. We created a multivariable logistic regression model adjusting for selected demographic and obstetric variables that may influence the likelihood of the primary outcome.<\/jats:p><jats:p>\n            Results\u2003A total of 14,570 women in the parent trial met inclusion criteria with an 18.8% incidence of the primary outcome (2,742 women). After adjusting for potential confounding variables, maternal surgical morbidity was found to be significantly higher for non-Hispanic Black (adjusted odds ratios [aORs] 1.96, 95% confidence intervals [CIs] 1.63\u20132.35) and Hispanic (aOR 1.66, 95% CI 1.37\u20132.01) women as compared with non-Hispanic white women. Neonatal morbidity was similarly found to be significantly associated with the Black race and Hispanic ethnicity.<\/jats:p><jats:p>\n            Conclusion\u2003In this cohort, the odds of cesarean-related maternal and neonatal morbidity were significantly higher for non-Hispanic Black and Hispanic women. These findings suggest race as a distinct risk factor for cesarean complications, and efforts to alleviate disparities should highlight cesarean section as an opportunity for improvement in outcomes.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0041-1739305","type":"journal-article","created":{"date-parts":[[2021,12,11]],"date-time":"2021-12-11T00:05:49Z","timestamp":1639181149000},"page":"1567-1572","source":"Crossref","is-referenced-by-count":15,"title":["Racial and Ethnic Disparities in Cesarean Morbidity"],"prefix":"10.1055","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7932-1987","authenticated-orcid":false,"given":"Adina R.","family":"Kern-Goldberger","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Whitney","family":"Booker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York"},{"name":"Division of Maternal-Fetal Medicine, Columbia University Irving Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Friedman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York"},{"name":"Division of Maternal-Fetal Medicine, Columbia University Irving Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Gyamfi-Bannerman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York"},{"name":"Division of Maternal-Fetal Medicine, Columbia University Irving Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,12,10]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.ajog.2009.10.864","article-title":"Racial\/ethnic disparities in obstetric outcomes and care: prevalence and determinants","volume":"202","author":"A S Bryant","year":"2010","journal-title":"Am J Obstet Gynecol"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"B9","DOI":"10.1016\/j.ajog.2017.11.591","article-title":"SMFM special report: putting the \u201cM\u201d back in MFM: reducing racial and ethnic disparities in maternal morbidity and mortality: a call to action","volume":"218","author":"J A Jain","year":"2018","journal-title":"Am J Obstet 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Breslin","year":"2019","journal-title":"BJOG"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1056\/NEJMoa0803267","article-title":"Timing of elective repeat cesarean delivery at term and neonatal outcomes","volume":"360","author":"A T Tita","year":"2009","journal-title":"N Engl J Med"},{"issue":"06","key":"ref13","doi-asserted-by":"crossref","first-page":"1460","DOI":"10.1097\/AOG.0000000000000735","article-title":"Racial and ethnic disparities in maternal morbidity and obstetric care","volume":"125","author":"W A Grobman","year":"2015","journal-title":"Obstet Gynecol"},{"issue":"02","key":"ref14","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1097\/AOG.0000000000002751","article-title":"Maternal outcomes by race for women aged 40 years or older","volume":"132","author":"W A Booker","year":"2018","journal-title":"Obstet 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disparities: a conceptual framework and maternal safety consensus bundle","volume":"47","author":"E A Howell","year":"2018","journal-title":"J Obstet Gynecol Neonatal Nurs"},{"issue":"05","key":"ref19","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1053\/j.semperi.2017.04.010","article-title":"Strategies to reduce disparities in maternal morbidity and mortality: patient and provider education","volume":"41","author":"J Jain","year":"2017","journal-title":"Semin Perinatol"}],"container-title":["American Journal of 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