Poster Session 4
Jocelyn Reckford, BA (she/her/hers)
Medical Student
Washington University School of Medicine in St. Louis
St. Louis, Missouri, United States
Nandini Raghuraman, MD, MSCI
Assistant Professor of Ob&Gyn
Washington University School of Medicine in St. Louis
St. Louis, Missouri, United States
Antonina I. Frolova, MD, PhD (she/her/hers)
Assistant Professor of Ob&Gyn
Washington University School of Medicine
St. Louis, Missouri, United States
Amanda C. Zofkie, MD
Assistant Professor of Ob&Gyn
Washington University School of Medicine in St. Louis
St. Louis, Missouri, United States
Sherri Jackson, MD, MPH
Washington University School of Medicine in St. Louis
St. Louis, Missouri, United States
Katherine H. Bligard, MA, MD
Assistant Professor of Ob&Gyn
Washington University School of Medicine in St. Louis
St. Louis, Missouri, United States
Jeannie C. Kelly, MD, MS (she/her/hers)
Associate Professor
Washington University School of Medicine in St. Louis
St. Louis, Missouri, United States
The need for interpreter services has been linked to poor health outcomes but remains understudied in the obstetric population. We sought to compare outcomes among patients whose primary language was not English between those who used an interpreter and those who did not.
Study Design:
We performed a retrospective cohort study of all patients delivering at an urban tertiary care center between 2021-2023 who self-reported their primary language as anything other than English. Patients were dichotomized between those who used an interpreter versus those who did not; all patients with non-English as a primary language are offered interpreter services. Our primary outcomes were mode of delivery, gestational age at delivery, and low birth weight (LBW, < 2500g); secondary outcomes included postpartum hemorrhage (PPH), shoulder dystocia, APGAR at 5 minutes, and perineal lacerations. Mann-Whitney U, chi-square, fisher exact, and multivariable logistic regression were performed appropriately.
Results:
767 patients reported a primary language other than English; 396 (51.6%) did not use an interpreter and 371 (48.4%) did. There were lower rates of Hispanic ethnicity (28% vs 43%, p< 0.001) and gestational hypertension (11% vs 16%, p=0.010), and higher rates of pre-existing diabetes (4.3% vs 1.3%, p=0.035) among patients who used interpreters, as well as differences in self-reported race between groups (Table 1). There were no differences in age, parity, BMI, or rates of chronic hypertension. Gestational age at delivery and LBW did not differ between cohorts (Table 2); most patients delivered at term with birthweights >2500g. However, there were increased odds of cesarean (aOR 1.08, 95% CI 1.02-1.14) and PPH (aOR 1.61, 95% 1.43-1.82) in the cohort who used an interpreter.
Conclusion:
For delivering patients whose primary language was not English, needing an institutional interpreter was associated with a higher risk of cesarean delivery and PPH. These results suggest that language barriers in the labor unit are an important target to improve outcomes, especially for those who require an interpreter.
