Presentation (CTI)

OBJECTIVES: Aspirin is a therapy recommended by the USPSTF and ACOG for preeclampsia prevention among pregnant people at risk for the disease. Patients who identify as Black in the US are less likely to receive aspirin therapy per these guidelines (Sacks et al, NEJM 2024). This retrospective study aimed to investigate how a 24/7 virtual maternity care program performed at achieving equity in aspirin therapy utilization for Black birthing people enrolled in Medicaid.
METHODS: Patients were included if they: (A) engaged with the program 1+ times during the first 28 weeks of pregnancy (i.e., prior to closure of the recommended aspirin initiation window), (B) attended a program visit, (C) were insured by Medicaid, and (D) met ACOG criteria for preeclampsia risk. Criterion A was applied to data between July 1 2024 and December 31 2024. Race was self-reported. We compared rates of initiation and uptake of low-dose aspirin for patients with preeclampsia risk, per ACOG guidelines. Intervention rates for patients who self-identified as Black were compared to rates for patients who did not identify as Black, including those whose race was unknown. Two-proportion Z test was used to estimate significance of differences. IRB waiver of informed consent was obtained.
RESULTS: Among those at risk for preeclampsia, Black birthing patients (N = 781) had an aspirin initiation rate of 56%, which was significantly 12% higher than patients who did not identify as Black (N = 1,151; p<0.0001). This rate was 538% higher than the rate reported for Black patients in literature (Wong et al, AJOG 2021).
CONCLUSIONS: The study found that the virtual maternity program was associated with higher initiation and uptake of aspirin therapy for Black birthing patients compared to non-Black birthing patients in a Medicaid population. This demonstrates the potential of telemedicine interventions to enhance healthcare equity for underserved populations.