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Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 2

(624) Impact of stigmatizing language on perinatal health outcomes of birthing individuals with diabetes

Thursday, January 30, 2025
4:00 PM – 6:00 PM  
Objective: Healthcare providers' biases can influence patients' care and health outcomes. These biases can manifest through verbal and written communication. In this study, we evaluated the impact of stigmatizing language in clinical notes on maternal and neonatal outcomes among individuals with perinatal diabetes.

Study Design: We conducted a retrospective cohort study from 2018-2019 of individuals with singleton, non-anomalous pregnancies diagnosed with pre-existing or gestational diabetes using an academic-community obstetric outcomes database. Using a Natural Language Processing (NLP) algorithm, we identified ADA-specified stigmatizing terms in electronic health record notes. We then compared the characteristics and outcomes of patients with and without documented stigmatizing language in their medical records.

Results: Out of 1433 individuals, 128 (9%) had stigmatizing language documented in their medical records during their pregnancy. Black individuals and those of another race were over three times more likely to have stigmatizing language than white individuals (p< 0.001).  Individuals described with stigmatizing language had birth one week earlier than their counterparts (median 38w0d vs 39w0d, p< 0.001). HgbA1c before birth was comparable between cohorts (median 5.9 vs. 5.5). Both groups had similar rates of glucose documented in the two weeks before birth, and those without stigmatizing language had more abnormal blood glucose levels recorded than those with stigmatizing language (73% vs 47%, p< 0.001). After adjusting for diabetes type and gestational age at delivery, no differences were seen between individuals with and without stigmatizing language in hypertensive disorders of pregnancy, NICU admission, or LGA infants.

Conclusion:

The presence of stigmatizing language documented in medical records was used more often in Black and other minoritized racial groups than white individuals and was not clearly associated with markers of worse glucose control. No differences in clinical outcomes were identified, suggesting stigmatizing language may be used biasedly.