RT Journal Article
SR Electronic
T1 Assessment of Obstetric Outcomes for New Mainers
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 4109
DO 10.1370/afm.21.s1.4109
VO 21
IS Supplement 1
A1 Prast, Brendan
YR 2023
UL http://www.annfammed.org/content/21/Supplement_1/4109.abstract
AB Context: Maine Medical Center (MMC) cares for many newly arrived, non-English speaking residents in its provision of obstetric services (4% of Maine’s population in 2018). These patients may be at-risk for health care disparities because of language barriers, low socioeconomic status and stressors from a history of trauma.Objective: There is an ongoing need to understand the impact of immigration status on labor and delivery. We hypothesized that obstetric patients who speak a language other than English will have a higher C-section rate compared to English-speaking patients.Study Design and Analysis Retrospective data collection and analysis with descriptive analysis of the demographics and clinical characteristics of patients. Final analysis was completed with Chi-square testing, t-tests and logistic regression.Setting: MMC, a large tertiary-care center in Portland, ME.Dataset/Population Studied: All patients who delivered a newborn at MMC from 1/1/2018-12/31/2019.Outcome Measures: Primary outcome was Cesarean section rate.Results: A total of 5,710 patients delivered at MMC in 2018 and 2019. 91.1% identified their primary language as English, 8.9% identified a non-English language preference (2.1% French, 1.2% Arabic, 1.0% Somali, 4.6% other). 2058/5,710 were c-section deliveries. There was no statistically significant difference in Cesarean section rates between English speaking (36.3%) and non-English speaking (34.1%) patients during 2018-2019 (p=0.22).Among non-English speakers, we did identify higher Gravidity, Parity, higher percentage Medicaid coverage and older age at delivery (all p<0.0001). Increasing Gravidity was associated with C-section, while increasing Parity was protective. Medicaid or Governmental insurance was found to be associated with C-section. Adjusting the crude OR for C-section for known confounders using logistic regression found OR= 0.82 (95% CI 0.66, 1.01) non-English speakers, compared to English speakers.Conclusion: Our study did not reveal increased odds of C-section by language spoken, despite adjusting for confounders. Future work with higher numbers of non-English speaking patients might reveal an adjusted rate of C–section to be significantly different than English speakers.