Disparities in Location of Service and Management of Early Pregnancy Loss: A Retrospective Cohort Study.

OBJECTIVE

To examine differences in the location of service and management for patients receiving early pregnancy loss (EPL) care based on racial/ethnic identity.

DESIGN

Retrospective cohort study.

SETTING

A single university-affiliated urban tertiary care centre in the United States.

POPULATION: A cohort of 796 received care for EPL at a single university-affiliated urban tertiary care centre from July 1, 2021, through June 30, 2023.

METHODS

Descriptive statistics for demographic factors were generated, reporting frequencies and percentages; continuous variables were expressed as a mean with standard deviation; and chi-squared tests were performed. Descriptive statistics were used to describe the demographics of this patient population and the frequency of location of service and management type. Multivariate logistic regression models assessed the relationship between the location of services (ED and GYN triage vs. other), management type (expectant vs. active management) and patient race and ethnicity. Statistics are reported as adjusted odds ratio (aOR) and 95% confidence interval (CI).

MAIN OUTCOME MEASURES: Location of service, management type.

RESULTS

There were differences in care location and management based on race/ethnicity. Black and Hispanic/Latinx patients were more likely to receive care in the emergency department or gynaecology triage compared to their White counterparts. Black patients were also more likely to receive expectant management and office procedural management compared to their White counterparts. Receiving treatment in the emergency department or gynaecology triage was associated with expectant management.

CONCLUSIONS

Racial disparities exist in both location of service and management type for EPL.