Structural racism is associated with adverse postnatal outcomes among Black preterm infants.
Structural racism is associated with adverse postnatal outcomes among Black preterm infants.
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DOI：
10.1038/s41390-022-02445-6
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发表时间：
2023-07
影响因子：
3.6
通讯作者：
Chambers, Brittany D.
中科院分区：
文献类型：
--
作者：
Karvonen, Kayla L.;McKenzie-Sampson, Safyer;Baer, Rebecca J.;Jelliffe-Pawlowski, Laura;Rogers, Elizabeth E.;Pantell, Matthew S.;Chambers, Brittany D.
结构性种族主义助长了不良围产期结果方面的种族差异。我们试图确定结构性种族主义是否与黑人早产儿出生后的不良结局有关。使用全州出生队列数据库和美国社区调查，对2011-2017年在加州早产（胎龄22-36周）的13，321名黑人分娩者进行了观察性队列研究。种族和收入隔离的量化指标集中在极端（ICE）分数。多变量广义估计方程回归模型被用来检验ICE评分与不良产后结局之间的关联：频繁的急诊就诊、再入院、出院前和出院后死亡，并根据婴儿和分娩者的特征和社会因素进行调整。在最不特权的ICE三分之一中早产的黑人分娩者更有可能有经历频繁急性护理的婴儿（粗风险比[cRR] 1.3 95% CI 1.2-1.4），再入院与特权三分位数的患者相比，他们第一年的死亡率（cRR 1.1 95%CI 1.0-1.2）和出院后死亡率（cRR 1.9 95%CI 1.2-3.1）。结果没有显着差异后，调整婴儿或分娩的人的特点。结构性种族主义有助于黑人早产儿出院后的不良后果。以种族和收入隔离衡量的结构性种族主义与黑人早产儿的不良产后结局相关，包括频繁的急诊就诊、再住院和出院后死亡。这项研究扩展了我们对结构性种族主义对黑人早产儿健康的影响的理解，超越了围产期，并加强了结构性种族主义导致早产儿产后不良结局种族差异的概念。必须将结构性种族主义确定为产后时期种族差异的主要原因，以优先考虑和实施适当的结构性干预措施，改善结果。
Structural racism contributes to racial disparities in adverse perinatal outcomes. We sought to determine if structural racism is associated with adverse outcomes among Black preterm infants postnatally. Observational cohort study of 13,321 Black birthing people who delivered preterm (gestational age 22–36 weeks) in California in 2011–2017 using a statewide birth cohort database and the American Community Survey. Racial and income segregation was quantified by the Index of Concentration at the Extremes (ICE) scores. Multivariable generalized estimating equations regression models were fit to test the association between ICE scores and adverse postnatal outcomes: frequent acute care visits, readmissions, and pre- and post-discharge death, adjusting for infant and birthing person characteristics and social factors. Black birthing people who delivered preterm in the least privileged ICE tertiles were more likely to have infants who experienced frequent acute care visits (crude risk ratio [cRR] 1.3 95% CI 1.2–1.4), readmissions (cRR 1.1 95% CI 1.0–1.2), and post-discharge death (cRR 1.9 95% CI 1.2–3.1) in their first year compared to those in the privileged tertile. Results did not differ significantly after adjusting for infant or birthing person characteristics. Structural racism contributes to adverse outcomes for Black preterm infants after hospital discharge. Structural racism, measured by racial and income segregation, was associated with adverse postnatal outcomes among Black preterm infants including frequent acute care visits, rehospitalizations, and death after hospital discharge. This study extends our understanding of the impact of structural racism on the health of Black preterm infants beyond the perinatal period and provides reinforcement to the concept of structural racism contributing to racial disparities in poor postnatal outcomes for preterm infants. Identifying structural racism as a primary cause of racial disparities in the postnatal period is necessary to prioritize and implement appropriate structural interventions to improve outcomes.
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影响因子：
2.5
作者：
Anderson, James G.;Rogers, Elizabeth E.;Steurer, Martina A.
通讯作者：
Steurer, Martina A.
影响因子：
12.7
作者：
Krieger, Nancy;Van Wye, Gretchen;Bassett, Mary T.
通讯作者：
Bassett, Mary T.
影响因子：
3.4
作者：
Huynh, M.;Spasojevic, J.;Krieger, N.
通讯作者：
Krieger, N.
影响因子：
12.7
作者：
KOTELCHUCK, M
通讯作者：
KOTELCHUCK, M
DOI：
10.1017/s1742058x11000130
发表时间：
2011-04
期刊：
Du Bois review : social science research on race
影响因子：
--
作者：
Gee GC;Ford CL
通讯作者：
Ford CL