Susan H Tran

Perinatal outcomes among different Asian-American subgroups

OBJECTIVE The objective of the study was to investigate the differences in perinatal outcomes between various Asian ethnic subgroups at a national level. STUDY DESIGN This is a retrospective cohort study of all non-Hispanic Chinese, Japanese, Filipino, Asian Indian, Korean, Vietnamese, Samoan, Guamanian, and Hawaiian women whose deliveries were recorded by US birth certificates within the year 2003. Perinatal outcomes were compared between groups and potential confounders controlled for with multivariable logistic regression. RESULTS We found significant differences (P < .001) in the incidence of all perinatal outcomes of interest among the different Asian subgroups. These differences persisted after adjusting for potential confounders. The incidence of diabetes in pregnancy varied from 2.9% (Korean) to 5.7% (Filipina). CONCLUSION Our study demonstrates significant differences in preterm labor, primary cesarean delivery, pregnancy-associated hypertension, eclampsia, diabetes in pregnancy, low birthweight, macrosomia, and cephalopelvic disproportion among Asian subgroups at a national level, affirming the importance of examining these subgroups separately.

Meconium-stained amniotic fluid is associated with puerperal infections ☆

OBJECTIVE The purpose of this study was to determine whether meconium-stained amniotic fluid is associated with puerperal infection and whether the quality of the meconium is further associated with this risk. STUDY DESIGN We designed a retrospective cohort study of all deliveries beyond 37 weeks gestational age from 1992 to 2002 at a single community hospital. Data were collected on rates of chorioamnionitis, endomyometritis, quality of amniotic fluid, and length of labor and analyzed with bivariate and multivariate analyses. RESULTS We found that, among the 43,200 women who were delivered at term, 18.9% of the women had meconium staining (8.8% thin, 5.5% moderate, 4.6% thick). Compared with deliveries with clear amniotic fluid, those with meconium-stained amniotic fluid had higher rates of chorioamnionitis (2.3% vs 4.1%, P<.001) and endomyometritis (1.0% vs 1.7%, P<.001). Further, the severity of meconium staining was associated with increased rates of infection. CONCLUSION We found that the presence and severity of meconium-stained amniotic fluid is associated with puerperal infection even when being controlled for confounders.