Racial Disparities in Parturient Urine Drug Screening at a Texas Level IV Maternal Care Centre: A Single-Centre Retrospective Study

Abstract

Objectives

We hypothesized that Black or African American (hereby referred to as Black) and Hispanic patients would have higher rates of urine drug screening (UDS) during pregnancy compared with White or Caucasian (herby referred to as White) patients at our hospital.

Methods

Patients who delivered at our hospital between 1 December 2020 and 31 May 2021 and between 1 December 2022 and 31 May 2023 and who were Black, Hispanic, or White were included in the final analysis. We performed separate bivariate analyses comparing White patients to either Black patients or Hispanic patients. We performed a multivariate logistic regression, including variables of interest designed to predict risk factors for UDS during pregnancy.

Results

A total of 457 Black, 813 Hispanic, and 1252 White patients were identified. During pregnancy, 187 (40.9%) Black patients had UDS compared with 265 (21.2%) White patients (P < 0.001). In addition, 258 (31.7%) Hispanic patients had UDS during pregnancy, which was statistically different compared with White patients (P < 0.001). A multivariate logistic regression found that identification as Black was independently associated with UDS during pregnancy (adjusted OR [aOR] 1.871; 95% CI 1.382–2.534, P < 0.001), identification as Hispanic was not independently associated (aOR 1.177; 95% CI 0.900–1.538, P = 0.234), and patients who delivered after the COVID-19 pandemic were less likely to receive UDS (aOR 0.783; 95% CI 0.621–0.987, P = 0.039).

Conclusion

Identification as Black and delivery during the COVID-19 pandemic were independently associated with increased adjusted odds of UDS during pregnancy at our hospital.