HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Carroll, K. N. Articles by Hartert, T. V. Search for Related Content PubMed PubMed Citation Articles by Carroll, K. N. Articles by Hartert, T. V. Related Collections Epidemiology/public health Medical complications of pregnancy

Racial Differences in Asthma Morbidity During Pregnancy

From Vanderbilt University School of Medicine, Departments of Pediatrics, Medicine, and Preventive Medicine, and the Division of General Pediatrics, Division of General Internal Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Center for Education and Research on Therapeutics, Center for Health Services Research; Department of Biostatistics, Mid-South Geriatric Research Education and Clinical Center; Quality Scholars Program, VA TN Valley Health Care System; General Clinical Research Center; and Meharry/Vanderbilt Center for Reducing Asthma Disparities, Nashville, Tennessee.

Objective: Little is known about racial differences in asthma outcomes during pregnancy. We performed a cohort study to estimate racial differences in maternal asthma outcomes in a low-income population of pregnant women in which blacks and whites have similar medical care access and benefits.

Methods: We conducted a population-based cohort study of asthma-related morbidity in black and white pregnant women enrolled in Tennessee’s Medicaid Program, TennCare. Pregnant women were identified through TennCare enrollment files linked to birth certificates, 1995–2001. Prepregnancy, women with asthma were identified using International Classification of Diseases, 9th Revision, codes for health care visits and pharmacy files for asthma medication. Adjusted relative rates (RR) of rescue corticosteroid prescriptions, emergency department (ED) visits, and hospitalizations during pregnancy were compared by race using Poisson regression.

Results: We identified 4,315 women with asthma (4%) from a population of 112,171 pregnant women of black or white race with at least 180 days of continuous enrollment in TennCare before pregnancy. Blacks were more likely to receive a course of rescue corticosteroids than whites (14.6% versus 11.9%, adjusted RR 1.35, 95% confidence interval [CI] 1.14–1.61), have an emergency department visit (16.7% versus 8.7%, adjusted RR 1.89, 95% CI 1.57–2.27), or be hospitalized for asthma (9.0% versus 5.2%, adjusted RR 1.73, 95% CI 1.34–2.24).

Conclusion: Pregnant women with asthma had high asthma-related morbidity. Black women had clinically significantly more morbidity than whites. There is a need to improve the medical care of low-income women with asthma, particularly black women.

Level of Evidence: II-2

This article has been cited by other articles:

				K. N. Carroll, T. Gebretsadik, M. R. Griffin, P. Wu, W. D. Dupont, E. F. Mitchel, R. Enriquez, and T. V. Hartert Increasing Burden and Risk Factors for Bronchiolitis-Related Medical Visits in Infants Enrolled in a State Health Care Insurance Plan Pediatrics, July 1, 2008; 122(1): 58 - 64. [Abstract] [Full Text] [PDF]

				K. N. Carroll, T. Gebretsadik, M. R. Griffin, W. D. Dupont, E. F. Mitchel, P. Wu, R. Enriquez, and T. V. Hartert Maternal Asthma and Maternal Smoking Are Associated With Increased Risk of Bronchiolitis During Infancy Pediatrics, June 1, 2007; 119(6): 1104 - 1112. [Abstract] [Full Text] [PDF]

				V E Murphy, V L Clifton, and P G Gibson Asthma exacerbations during pregnancy: incidence and association with adverse pregnancy outcomes Thorax, February 1, 2006; 61(2): 169 - 176. [Abstract] [Full Text] [PDF]