(753) Obstetrical and Perinatal Trends in Hawai'i from 2019 to 2023

The State of Hawai’i is known to have one of the most diverse populations in the Unites States and faces unique social, cultural, and geographic barriers that impact maternal health. We aimed to assess the most recent pregnancy outcomes in Hawai’i to identify communities at higher risk.

Study Design:

Pregnancy outcomes were abstracted from the EHR at Kapiolani Medical Center for Women & Children (KMC) from January 2019 to June 2023 as part of Hawai’i Pacific Health Quality Improvement. KMC is the only tertiary mother-baby referral hospital in the Pacific Basin. A total of 24,303 singleton deliveries with gestational age greater than 20 weeks and birth weight greater than 400g were analyzed. Clinical diagnoses were grouped by ICD-10 codes: e.g., hypertensive disorders (pre-existing and gestational), diabetic disorders (pre-gestational and gestational), and pre-eclampsia. Preterm births were defined as < 37 weeks and very preterm < 32 weeks. Growth disturbances were defined by low birth weight < 2500g and macrosomia >4000g. Descriptive analysis, Chi-square tests, and ANOVA were performed on Intellectus Statistics software.

Results:

Table 1 summarizes the results. Pregnant persons identifying as Native Hawaiian and Other Pacific Islander (NHOPI) experienced the highest rate of preterm delivery. Both NHOPI and Black or African American pregnant people had similarly high rates of hypertensive disorders. Asians experienced the highest rate of diabetic disorders in pregnancy. In fact, Asians were diagnosed with diabetes at a much lower BMI than all other racial/ethnic groups.

Conclusion:

NHOPI people experience the highest rates of preterm birth. Asian pregnant persons experience diabetic disorders at much lower BMI than all other groups. Further studies are necessary to elucidate the pathophysiology of these observations in order to promote health equity.