A Critical Review on the Use of Race in Understanding Racial Disparities in Preeclampsia.
A Critical Review on the Use of Race in Understanding Racial Disparities in Preeclampsia.
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关于种族在理解子痫前期种族差异中使用种族的批判性综述。
DOI：
10.1093/jalm/jfaa149
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发表时间：
2021-01-12
期刊：
影响因子：
--
通讯作者：
Beal SG
中科院分区：
文献类型：
--
作者：
Fasanya HO;Hsiao CJ;Armstrong-Sylvester KR;Beal SG
子痫前期是孕产妇发病和死亡的一个重要原因，影响全球高达8%的妊娠。虽然确切的病因仍在研究中，但文献表明血管改变减少胎盘灌注并影响螺旋动脉重塑，从而产生子痫前期的标志性特征：血压升高。目前建议所有孕妇进行先兆子痫筛查，特别是在存在危险因素的情况下。指南中提到的一个风险因素是“非裔美国人种族”。我们总结了子痫前期的发病率、发病率和死亡率的种族差异。我们通过考察多民族、移民和国际研究来考虑使用种族来理解差异的局限性。然后，我们批判性地评估与先兆子痫种族差异相关的实验室分析，并探索其他作用机制，如社会经济地位、压力和获得护理的机会。黑人和非裔美国妇女的先兆子痫发生率、发病率和死亡率始终高于白人妇女。亚洲女性患先兆子痫的风险一直较低，而与西班牙裔女性的关系尚不清楚。当这些广泛的种族类别按地理或文化来源细分时，就可以确定种族群体中的子痫前期差异。有限的文献表明，撒哈拉以南非洲移民患先兆子痫的风险往往高于美国出生的白人，但低于美国出生的黑人妇女。现有的研究试图确定分析物中的种族差异，研究设计有限，并且倾向于将种族作为种族之间生物固有（即遗传）差异的代理，尽管存在大量其他可能的解释机制。
Preeclampsia is a significant cause of maternal morbidity and mortality, affecting up to 8% of pregnancies globally. Although the precise etiology is still under study, the literature suggests that vascular changes reduce placental perfusion and affect the remodeling of spiral arteries to create the hallmark feature of preeclampsia: elevated blood pressure. Screening for preeclampsia is currently recommended for all pregnant women, particularly if risk factors exist. A noted risk factor codified in guidelines is “African-American race.” We summarize the racial disparities in preeclampsia incidence, morbidity, and mortality. We consider the limitations of using race to understand disparities by also examining multiethnic, immigration, and international studies. We then critically evaluate laboratory analytes associated with racial disparities of preeclampsia and explore other mechanisms of action, such as socioeconomic status, stress, and access to care. Black and African-American women are consistently at higher risk of preeclampsia incidence, morbidity, and mortality than their white counterparts. Asian women are consistently at lower risk of preeclampsia, whereas the association for Hispanic women remains unclear. When these broad racial categories are subdivided by geographic or cultural origin, preeclampsia disparities within racial groups are identified. The limited literature suggests that sub-Saharan African immigrants tend to have a higher risk of preeclampsia than US-born white populations but a lower risk than US-born Black women. Existing studies seeking to identify racial differences in analytes have limited research designs and tend to operationalize race as a proxy for biologically inherent (i.e., genetic) differences between races despite a plethora of other possible explanatory mechanisms.
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DOI：
10.1007/s40615-019-00619-3
发表时间：
2019-12-01
影响因子：
3.9
作者：
Ross, Kharah M.;Schetter, Christine Dunkel;Jelliffe-Pawlowski, Laura
通讯作者：
Jelliffe-Pawlowski, Laura
影响因子：
2.8
作者：
Gong, Jian;Savitz, David A.;Engel, Stephanie M.
通讯作者：
Engel, Stephanie M.
DOI：
10.1080/14767058.2019.1581522
发表时间：
2020-11-01
影响因子：
1.8
作者：
Gyamfi-Bannerman, Cynthia;Pandita, Ambika;Friedman, Alexander M.
通讯作者：
Friedman, Alexander M.
影响因子：
3.1
作者：
Ng, Shu-Kay;Cameron, Cate M.;Scuffham, Paul A.
通讯作者：
Scuffham, Paul A.
影响因子：
3.2
作者：
Markus, Anne Rossier;Andres, Ellie;Pellegrini, Cynthia
通讯作者：
Pellegrini, Cynthia