Author Interviews, OBGYNE, Race/Ethnic Diversity / 16.01.2020
Within-Hospital Racial Disparities in Maternal Complications Persist
MedicalResearch.com Interview with:
[caption id="attachment_52827" align="alignleft" width="130"]
Dr. Howell[/caption]
Elizabeth A. Howell, MD, MPP
Director of The Blavatnik Family Women’s Health Research Institute
Mount Sinai Health System Vice Chair for Research
Professor in the Department of Obstetrics, Gynecology, and Reproductive Science
Associate Dean for Academic Development
Professor Department of Population Health Science and Policy
Icahn Mount Sinai, New York
MedicalResearch.com: What is the background for this study?
Response: Previous research has demonstrated racial and ethnic disparities in severe maternal morbidity rates in hospitals and that between-hospital differences -- i.e., Black and Latina mothers receiving care at hospitals with worse outcomes -- explain a sizable portion of these disparities. However, less attention has been paid to within-hospital disparities -- whether Black and Latina mothers have worse outcomes than White mothers who deliver in the SAME hospital.
In this paper, we set out to measure within-hospital racial and ethnic disparities and to evaluate the potential contribution of insurance type to these disparities.
Our study question was based on the observation that women with Medicaid can follow different care pathways than women with private insurance. Pregnant women insured by Medicaid are often seen by resident physicians with attending coverage that may differ from attending physicians caring for commercially insured women. In addition, Medicaid reimbursement for delivery hospitalization is far less than that for commercially insured.
Dr. Howell[/caption]
Elizabeth A. Howell, MD, MPP
Director of The Blavatnik Family Women’s Health Research Institute
Mount Sinai Health System Vice Chair for Research
Professor in the Department of Obstetrics, Gynecology, and Reproductive Science
Associate Dean for Academic Development
Professor Department of Population Health Science and Policy
Icahn Mount Sinai, New York
MedicalResearch.com: What is the background for this study?
Response: Previous research has demonstrated racial and ethnic disparities in severe maternal morbidity rates in hospitals and that between-hospital differences -- i.e., Black and Latina mothers receiving care at hospitals with worse outcomes -- explain a sizable portion of these disparities. However, less attention has been paid to within-hospital disparities -- whether Black and Latina mothers have worse outcomes than White mothers who deliver in the SAME hospital.
In this paper, we set out to measure within-hospital racial and ethnic disparities and to evaluate the potential contribution of insurance type to these disparities.
Our study question was based on the observation that women with Medicaid can follow different care pathways than women with private insurance. Pregnant women insured by Medicaid are often seen by resident physicians with attending coverage that may differ from attending physicians caring for commercially insured women. In addition, Medicaid reimbursement for delivery hospitalization is far less than that for commercially insured.

Dr. Hui Wang[/caption]
Prof Hui Wang PhD
Wuhan University
China
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We started our work in the adverse outcome of maternal caffeine intake during pregnancy about 15 years ago. Then, we found that prenatal caffeine intake could result in nonalcoholic fatty liver disease in the offspring. However, the underlying mechanism was unclear.
So, we start the current work, and found that hat maternal caffeine intake disrupts liver development before and after birth, which might be the trigger of the adult non-alcoholic fatty liver disease in the offspring rats. Moreover, we further found that the fetal programming of liver glucocorticoid – insulin like growth factor 1 axis, a new endocrine axis first reported by our team, might participate in such process.

