OBJECTIVES: To report the cumulative incidence of postpartum complications after birth by race and ethnicity among women of childbearing age covered by public Medicaid insurance in the United States.

METHODS: Women of childbearing age (ages: 15-44) with a birth (livebirth or still birth) in 2022 were identified in the Merative^TM MarketScan^Ò Multi-state Medicaid Database. The cumulative incidence of postpartum complications per 10,000 women were reported for postpartum hemorrhage (≤14 days of birth), postpartum infections (≤42 days of birth), acute kidney failure (≤42 days of birth), and postpartum depression (≤365 days of birth). The cumulative incidence ratio (IR) with 95% confidence intervals were reported by race and ethnicity with White women as the reference.

RESULTS: A total of 103,502 women [White (n=55,777)], Black (n=37,606), and Hispanic (n=9,669)] were included. Both Black women [577.6 vs. 517.1 per 10,000 (IR: 1.12; 1.06-1.18)] and Hispanic women [909.1 vs. 517.1 per 10,000 (IR: 1.76; 1.64-1.89)] had a higher cumulative incidence of postpartum hemorrhage. Hispanic women had a higher cumulative incidence of postpartum sepsis [23.8 vs. 12.7 per 10,000 (IR: 1.87; 1.17-2.99)]. The cumulative incidence of acute kidney failure was higher for both Black [16.5 vs. 5.9 per 10,000 (IR: 2.79; 1.83-4.25)] and Hispanic women [18.6 vs. 5.9 per 10,000 (IR: 3.14; 1.77-5.59)]. Lastly, Black [1,342.6 vs. 2,337.0 per 10,000 (IR: 0.57; 0.56-0.59)] and Hispanic [1,801.6 vs. 2,337.0 per 10,000 (IR: 0.77; 0.74-0.81)] women both had a lower cumulative incidence of postpartum depression.

CONCLUSIONS: Disparities in the cumulative incidence of postpartum complications among women with Medicaid were not consistent across outcomes. Minority women had a higher incidence of postpartum hemorrhage and acute kidney failure while White women had a higher incidence of postpartum depression. Results indicate a better understanding of disparities by race and ethnicity to improve