A Close-up Examination of Racial Disparities in Infant and Maternal Outcomes in Montgomery County, Ohio

Background: Infant and maternal outcomes in Montgomery County, Ohio, are among the worst in the state and rival that of many low-income nations. This study compares maternal and infant outcomes across 3 zip codes in Montgomery County to discern factors that are influencing health outcomes for their residents. The zip codes represent 3 distinct communities with unique racial and socioeconomic makeups. Methods: A cohort of mother-infant dyads (n=5098) who delivered at Miami Valley Hospital and Good Samaritan Hospital from January 1, 2009, to January 1, 2019, was analyzed via retrospective chart review. Maternal health outcome composite score (MCS) and infant health outcome composite score (ICS) from Trotwood, Ohio, (zip code 45426) were compared to those of 2 nearby zip codes (45415 and 45424), which were chosen for their lower infant mortality rates and proximity to Trotwood. Continuous variables were compared by ANOVA followed by post hoc Tukey tests. Categorical variables were compared via chi-square analysis. Results: The MCS and ICS were stratified by zip code and maternal age, race, and BMI. There was a statistically significant difference in MCS for race and BMI across all zip codes, but no statistically significant difference for maternal age. There was no statistically significant difference in ICS across maternal age, race, and BMI. Conclusion: Maternal outcomes for Black women were consistently worse across communities while outcomes for other races varied. Our study shows that maternal outcomes did not correlate with infant outcomes, indicating that interventions focusing on improving maternal outcomes may be inadequate at addressing infant outcomes. Investigations surrounding race-specific interventions in all populations are needed.