Racial health disparities in severe maternal morbidity before and after implementation of an enhanced recovery after cesarean delivery protocol: a retrospective observational study at two New York City hospitals (2016–2020)
Authors' conclusion
Implementation of the ERAC protocol improved SMM outcomes by race.
Study context
- Population
- Cesarean delivery patients at two large academic hospitals in New York City, October 2016 to September 2020
- Participants
- 7,812 patients
- Exposure
- Severe maternal morbidity (SMM) by race before vs after ERAC implementation
- Pre-ERACn = 4,640
- Post-ERACn = 3,172
- Outcome
- Peripartum severe maternal morbidity (SMM) by race
Methodological detailstwo-centre, pre-post implementation
- Two-centre
- Pre-post implementation
Main finding
As reported in the abstract
SMM by race, pre- and post-ERAC (subgroup)
Each group vs whiteAdjusted odds ratio (95% CI)P value
BlackPre-ERAC
1.92(1.16–3.14)
P = 0.010AsianPre-ERAC
1.86(1.26–2.74)
P = 0.002BlackPost-ERAC
1.13(0.61–2.01)
P = 0.69AsianPost-ERAC
1.39(0.88–2.17)
P = 0.15Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| SMM by race, overall populationBlack vs white | 1.57 (1.07–2.28) | P = 0.018 | |
| SMM by race, overall populationAsian vs white | 1.61 (1.20–2.14) | P = 0.001 | |
| 0.512Adjusted odds ratio (log scale) |
Original publication
Racial health disparities in severe maternal morbidity before and after implementation of an enhanced recovery after cesarean delivery protocol: a retrospective observational study at two New York City hospitals (2016–2020). Int J Obstet Anesth. Published 27 March 2025. doi:10.
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