Associations between ethnicity and obstetric anaesthetic care in Wales.

 

Introduction Inequalities in healthcare have been a growing concern, with a recent study in England highlighting significant disparities in obstetric anaesthetic care for patients from different ethnicities [1]. We investigated the association between ethnicity and type of anaesthesia for caesarean deliveries (CD) for the first time in Wales.

 

Methods Utilizing routinely collected data from maternity records in one tertiary centre, we examined the association between ethnicity and the use of general anaesthesia (GA) for CD. Ethnicity was classified into 2021 census categories. We performed Chi-square tests to assess the initial association, followed by logistic regression analysis to adjust for covariates including maternal age, parity, and Welsh Index of Multiple Deprivation.

 

Results Our dataset covered 57788 births, of which 14950 were CD, with 445 performed under GA, over a 10-year period. There was statistically significant association between ethnicity and the type of anaesthesia (p<0.05). Logistic regression analysis (Figure 1) showed that Mixed (White and Black African) women were 2.8 times more likely to receive GA compared to White British women. Likelihood of GA was high for Black or Black British (Caribbean) (aOR 2.06 ) and Any other mixed background (aOR 1.80).

 

Discussion Consistent with prior research [1], our findings indicate variations in anaesthetic care during CDs across different ethnic groups. Limitations included the inability to adjust for other covariates, such as medical comorbidities. These results emphasise the need for culturally and ethnically sensitive healthcare policies and further research to unravel any causal factors behind these disparities, improving equity in the provision of obstetric anaesthetic care.