Obstetric Anaesthesia Annual Scientific Meeting 2023

Socioeconomic deprivation, ethnicity & postpartum outcomes following caesarean delivery.

Liana Zucco, Eleanor Warwick, Nan Guo, Brendan Carvalho, Pervez Sultan, James O’Carroll

Background:

Following the national multi-centre ObsQoR study, we explored the relationship between ethnicity, socioeconomic status & postpartum recovery following childbirth in the UK.

Methods:

Eligible, consenting patients having caesarean deliveries have been analysed in a subset from the main data set..

Data collected included:

•Demographic, maternal, obstetric, neonatal & anaesthetic

•The Index of Multiple Deprivation (IMD), used as a measure of socioeconomic status.

•Patient centric outcomes (EQ-5D, ObsQoRscores), during the inpatient and outpatient period

Analysis:

•Assessment of differences between reported ethnic groups.

•Linear regression analysis, to understand effects of possible confounding

Results:

1000 patients were included in the analyses.

•No difference between ethnic groups: Age, BMI, ASA status, parity, gestational age or PMH (except for diabetes and sickle cell disease)

•More Asian, Black and Mixed ethnicities were seen in the more deprived quintiles.

Disparity in LOS:

•White patients had shorter LOS than Asian and Black patients (35 [27.6-55.6] hrs vs 44.3 [31.0-70.5]p=0.021, and 48.9 [32.9-74.8] p=0.009 respectively)

Disparity in pain scores:

•White patients reportedlower pain scores at both day 1 and day 30.

•White patients reported higher inpatient ObsQoRscores

At day 1:

•Asian patients reportedmore pain (b= 0.79 (0.30, 1.28); p=0.002)

•Black patients reported higher global health VAS scores (b=7.02 (2.05, 11.99); p=0.006).

At 30 days:

•Asian patients reported worse pain scores (b=0.65 (0.29, 1.02); p=<0.001).

•No differences were seen in readmission rates or complications across all patient groups

Discussion:

This national study demonstrates disparities in UK obstetric patients, with differences in recovery related to ethnicity status even when correcting for socioeconomic group. Further work is imperative to understand the underlying reasons for this disparity. This is one of the most important areas for the future of obstetric care

Obstetric Anaesthesia Annual Scientific Meeting 2023

Socioeconomic deprivation, ethnicity and postpartum outcomes following caesarean delivery

Poster Presenter

Authors

Affiliations

Part of Topic