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Association between weighted adverse outcome score and race/ethnicity in women and neonates



To examine the association between the Weighted Adverse Outcome Score (WAOS) and race/ethnicity among a large and diverse population-based cohort of women and neonates in the United States.

Study design

This was a retrospective cohort study of women who delivered in the United States between 2011 and 2013. We identified mother-infant pairs with adverse maternal and/or neonatal outcomes. These outcomes were assigned weighted scores to account for relative severity. The association between race/ethnicity and WAOS was examined using chi-square test and multivariable logistic regression.


Compared to White women and their neonates, Black women and their neonates were at higher odds of an adverse outcome.


The vast majority of women and neonates had no adverse outcome. However, Black women and their neonates were found to have a higher WAOS. This tool could be used to designate hospitals or regions with higher-than-expected adverse outcomes and target them for intervention.

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Fig. 1: Weighted Adverse Outcome Score Breakdown.


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LMY was supported by the NICHD K12 HD050121-11 at the time of the study.

Author information




SB and LY designed the analysis and wrote the paper, YC designed and performed the analysis, AC designed the analysis and assisted in writing the paper.

Corresponding author

Correspondence to Saba H. Berhie.

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The authors declare no competing interests.

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Berhie, S.H., Cheng, Y.W., Caughey, A.B. et al. Association between weighted adverse outcome score and race/ethnicity in women and neonates. J Perinatol (2021).

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