Correlates for Transfusion at Delivery Among Latinx Birthing Patients at a Tertiary Care Center [ID 2683569]

INTRODUCTION: We observed a higher transfusion rate among Latinx compared to non-Latinx individuals. We sought to determine whether this disparity resulted from preexisting anemia or acute blood loss at delivery, to devise targeted prevention strategies. METHODS: We conducted a retrospective cohort study of 1,960 births between April 1, 2021, and March 31, 2022. Demographic and obstetric factors, hematocrit (Hct), pregnancy outcomes, and anemia treatment were abstracted. Anemia was defined as Hct less than 33%. Statistical differences between groups were evaluated by chi-squared or independent-sample t -tests. Odds ratios (ORs) and 95% CIs were calculated by logistic regression, adjusting for confounders. RESULTS: Transfusion at delivery occurred among 21 (8.0%) Latinx and 77 (4.5%) non-Latinx patients (OR 1.84; 95% CI, 1.12–3.04; P =.015). Latinx patients were younger (mean 30 versus 32 years; P <.001), more likely to receive Medicaid (85% versus 80%; P =.05), not speak English (21% versus 6%; P <.001), deliver preterm less than 37 weeks (33% versus 19%; P <.001), and have complex cesarean delivery (CD) (5.7% versus 3.2%; P =.049). Preexisting anemia was statistically associated with transfusion ( P <.001) but not with Latinx ethnicity. Oral and intravenous iron did not differ between groups. After adjustment for anemia and CD, Latinx ethnicity remained significantly associated with transfusion (adjusted OR 1.73; 95% CI, 1.18–2.28; P =.04). CONCLUSION: Latinx patients were more likely to require complex CD; with preexisting anemia, this likely increased the risk for transfusion. Recognition of risk factors for complex CD in addition to prompt diagnosis and management of anemia are key for preventing transfusions.