Alexander J. Butwick|Yair J. Blumenfeld|Kathleen Brookfield|Lorene M. Nelson|Carolyn F. Weiniger
Racial and Ethnic Disparities in Mode of Anesthesia for Cesarean Delivery
Stanford University|Stanford University|Stanford University|Stanford University|Stanford University|Hadassah Medical Center
brief background racial ethnic disparities identified provision neuraxial labor analgesia disparities may exist key aspects obstetric anesthesia care sought determine whether racialethnic disparities exist mode anesthesia cesarean delivery cd methods women underwent cd 1999 2002 19 different obstetric centers united states identified maternalfetal medicine units network cesarean registry raceethnicity categorized caucasian african american hispanic nonhispanic others nhos mode anesthesia classified neuraxial anesthesia spinal epidural combined spinalepidural anesthesia general anesthesia account obstetric nonobstetric covariates may influenced mode anesthesia multiple logistic regression analyses performed using sequential sets covariates results study cohort comprised 50974 women underwent cd rates general anesthesia among racialethnic groups follows 52 caucasians 113 african americans 58 hispanics 66 nhos adjustment obstetric nonobstetric covariates african americans highest odds receiving general anesthesia compared caucasians adjusted odds ratio aor 17 95 confidence interval ci 1518 p 0001 odds receiving general anesthesia also higher among hispanics aor 11 95 ci 1013 p 002 nhos aor 12 95 ci 1014 p 003 compared caucasians respectively sensitivity analysis reconstructed models excluding women underwent neuraxial anesthesia general anesthesia adjusted odds receiving general anesthesia similar main analysis african americans aor 17 95 ci 1519 p 0001 hispanics aor 12 95 ci 1114 p 0006 nhos aor 12 95 ci 1015 p 005 conclusions based data cesarean registry african american women highest odds undergoing general anesthesia cd compared caucasian women uncertain whether disparity exists current obstetric practice published ahead print march 14 2015