Table 3.
Decomposition of the Black-White difference in SMM during delivery through 42 days postpartum
| Characteristics | Model 1a | Model 2b Hospital Fixed-effects |
|---|---|---|
| Non-Hispanic Black and White (n=413,124) | Non-Hispanic Black and White (n=413,124) | |
| SMM rate (per 100 deliveries) delivery to 42 days postpartum: Black-White difference | 1.421 | 1.421 |
| Explained gap | 0.431 (30.4%)c | 0.708 (49.8%)c |
| Maternal sociodemographic factors | 0.144 (10.1%)c | 0.205 (14.4%)c |
| Married | 7.6% | 10.3% |
| Education | 4.3% | 6.4% |
| US born | -0.2% | -0.3% |
| Age | -1.6% | -2.1% |
| Medical factors | 0.054 (3.8%)c | 0.08 (5.6%)c |
| Gestational hypertension | 2.4% | 3.3% |
| Chronic hypertension | 2.1% | 3.1% |
| Diabetes mellitus | 0.6% | 0.9% |
| Gestational diabetes | 0.0% | -0.1% |
| Smoker | -1.2% | -1.6% |
| Obstetrical factors | 0.04 (2.8%)c | 0.057 (4.0%)c |
| Birth order | 2.5% | 3.6% |
| Singleton birth | 0.3% | 0.5% |
| Access to care | 0.146 (10.3%)c | 0.211 (14.9%)c |
| Payer type | 9.0% | 13.3% |
| No or third trimester prenatal care | 1.3% | 1.5% |
| Hospital Characteristics | 0.067 (4.7%)c | 0.046 (3.2%) |
| Delivery Volume | 2.6% | 1.3% |
| Ownership | 1.7% | – |
| Perinatal Level | 1.2% | – |
| Patient Safety Indicator Score | 1.1% | 3.1% |
| Deliveries per RN FTE | 0.4% | -0.1% |
| Teaching Status | 0.2% | – |
| Doctor Communication | -2.4% | -1.1% |
| Residential Characteristics | -0.022 (-1.6%) | -0.107 (-7.5%) |
| NDI | 4.9% | 4.0% |
| Ob/Gyn per 10,000 WRA | 0.9% | -0.8% |
| Number of Comm. Mental Health Centers | 0.5% | 0.2% |
| Medically Underserved Area | -0.1% | 0.1% |
| Residential Area | -0.2% | -4.5% |
| Percent Uninsured WRA | -2.2% | -1.8% |
| FQHC | -5.3% | -4.7% |
| Year of Delivery | 0.003 (0.2%)** | 0.002 (0.1%) |
| Hospital Fixed-effects | – | 0.214 (15.1%)** |
| Unexplained gap | 0.99 (69.6%)c | 0.713 (50.2%)c |
FQHC, federally-qualified health center; FTE, fulltime equivalent; NDI, Neighborhood deprivation index; RN, registered nurse; WRA, women of reproductive agez.
a
Adjusted for all characteristics presented
b
Adjusted for all characteristics presented and hospital fixed-effects. Hospital fixed-effects are not shown. Time-invariant hospital characteristics of hospital ownership, teaching status, and perinatal level excluded from fixed-effects models.
c
P<.001.
Adams. Examining the Black-White gap in severe maternal morbidity. Am J Obstet Gynecol Glob Rep 2024.