Poster Session 2
Category: Health Equity/Community Health
Poster Session 2
Daniella Rogerson-Lewis, MD, MS (she/her/hers)
Resident Physician
University of California San Diego Health
San Diego, California, United States
Carolina Thorlund-Díaz, MPH
University of California San Diego
University of California San Diego, California, United States
Marni B. Jacobs, PhD
Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego
San Diego, California, United States
Lillian Blank, BS
University of California San Diego
San Diego, California, United States
Leilani Gutierrez-Palominos, MD
University of California San Diego
University of California San Diego, California, United States
Ayelet Ruppin-Pham, RN
University of California San Diego
University of California San Diego, California, United States
Maryam Tarsa, MD
Professor
Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego
San Diego, California, United States
E. Nicole Teal, MD, MPH (she/her/hers)
Assistant Professor, Division of Maternal-Fetal Medicine
Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego
San Diego, California, United States
Low dose aspirin (LDA) reduces preeclampsia (preE) risk, yet prescribing rates among eligible pregnant patients remain low. This study aims to determine whether there are disparities in LDA prescription to eligible patients based on race/ethnicity, primary language, or insurance after implementation of a standardized electronic health record (EHR) preE risk screening tool.
Study Design:
This retrospective cohort study included all patients ≥ age 18 with births at a single academic center from 9/1/22 to 7/15/25 who had 1 high [multifetal gestation, chronic hypertension (CHTN), diabetes mellitus (DM), renal disease, lupus] or ≥2 moderate (nulliparity, obesity, age ≥35) preE risk factors documented via screening tool or ICD10 code. The primary outcome was LDA recommendation/prescription rate, determined by recommendation documentation in the risk screening tool or prescription in the EHR medication log. Data were extracted from Epic Clinical Data Warehouse. Chi-square or t-tests were used to compare LDA prescribing rates by race/ethnicity, primary language, and insurance, and multivariable regression models were used.
Results:
Of 5,737 LDA eligible patients, 3,995 (69.6%) were recommended/prescribed LDA and 1,7442 (30.4%) were not. Patients recommended/prescribed LDA were more likely to be older, multiparous, English speaking, and privately insured and/or have DM or CHTN (Table 1). In a multivariable analysis, Black/African American patients had higher odds of being prescribed/recommended LDA (aOR 1.80, 95% CI 1.36-2.39) while non-English speaking and publicly insured patients had lower odds (Spanish aOR 0.60, 95% CI 0.46-0.78; other language aOR 0.62, 95% CI 0.45-0.85; public insurance aOR 0.80, 95% CI 0.69-0.93) (Table 2).
Conclusion:
After implementation of a standardized preE risk screening tool, LDA was more often prescribed to eligible Black patients than White, likely reflecting ACOG’s inclusion of Black race/racism as a preE risk factor. However, LDA was less often prescribed to publicly insured or non-English speaking patients, which highlights an opportunity for quality and equity improvement.