Age and racial/ethnic differences in maternal, fetal, and placental conditions in laboring patients

Objective: Most health indicators exhibit evidence of ethnic disparity. This study describes the prevalence of clinical conditions that are associated with pregnancy, stratified at age 35 years, and by ethnicity (black, white, Hispanic, other). Study Design: This was a retrospective, cross-sectional cohort study. We used International Classification of Diseases discharge diagnostic codes from California discharge data to identify 31 maternal, fetal, and placental conditions. Results: At least one condition was present for 26.1% of the 443,532 eligible women. There was variation in risk by age and race/ethnicity and differences by age within ethnic groups. Black women were more at risk; there are 12 conditions for older women, and there are 16 conditions for younger women. Hispanic women showed a higher risk for diabetes mellitus, macrosomia, and severe hypertension. All white women showed a higher risk for cardiac conditions and isoimmunization, whereas older white women also demonstrated an increased risk for herpes infection and multiple gestation. Conclusion: Older women and black women have more morbidity. The degree to which these clinical conditions affect labor management and obstetric outcomes needs further evaluation. (Am J Obstet Gynecol 2003;188:1602-8.)