Health disparities in preterm births.
Health disparities in preterm births.
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DOI：
10.3389/fpubh.2023.1275776
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发表时间：
2023
影响因子：
5.2
通讯作者：
Casavant, Sharon G.
中科院分区：
文献类型：
--
作者：
Brown, Judy;Chang, Xiaolin;Matson, Adam;Lainwala, Shabnam;Chen, Ming-Hui;Cong, Xiaomei;Casavant, Sharon G.
与非西班牙裔白人(W)妇女相比，非裔美国人(B/AA)妇女早产的风险增加了2倍至3倍。此外，早产是B/AA婴儿死亡的主要原因，在幸存者中，B/AA婴儿不成比例地出现早产儿不良健康后果。产妇和婴儿健康方面的种族不平等继续构成公共健康危机，尽管这一发现早在100年前就已被发现。这项研究的目的是扩大已报道的早产儿结局差异。一种生命过程的方法，包括歧视在内的终身压力的积累，可以解释导致早产率和B/AA母亲结局不平等的社会因素。197名同意的参与者的人体测量和临床治疗信息是从电子健康记录中收集的，时间跨度为4 。采用新生儿应激源量表对急性和慢性疼痛/应激性手术进行评分。神经行为差异采用新生儿重症监护病房(NICU)网络神经行为量表进行调查。B/AA级母亲早产早于W级母亲。与年龄匹配的W早产儿相比，显著小于B/AA早产儿的NICU住院时间延长了2 周以上。在B/AA早产儿中，有更多的慢性救命手术显示出应激反应模式的改变。这项对早产率和早产儿发育和神经发育结果的横断面分析是在NICU压力和疼痛的背景下提出的，并伴随着对婴儿死亡率和未来健康差距的影响。早产儿出生率和结局不平等进一步表明，需要制定干预措施和政策，减少歧视的影响，改善黑人、土著和其他有色人种健康的社会决定因素。
Black African American (B/AA) women have a 2-fold to 3-fold elevated risk compared with non-Hispanic White (W) women for preterm birth. Further, preterm birth is the leading cause of mortality among B/AA infants, and among survivors, preterm infant adverse health outcomes occur disproportionately in B/AA infants. Racial inequities in maternal and infant health continue to pose a public health crisis despite the discovery >100 years ago. The purpose of this study was to expand on reported preterm infant outcome disparities. A life-course approach, accumulation of lifelong stress, including discrimination, may explain social factors causing preterm birth rate and outcome inequities in B/AA mothers. Anthropometric measures and clinical treatment information for 197 consented participants were milled from electronic health records across 4 years. The Neonatal Infant Stressor Scale was used to tally acute and chronic painful/stressful procedures. Neurobehavioral differences were investigated using the Neonatal Intensive Care Unit (NICU) Network Neurobehavioral Scale. B/AA mothers gave birth to preterm infants earlier than W mothers. NICU hospitalization stays were extended more than 2 weeks for the significantly smaller B/AA preterm infants in comparison to the age-matched W preterm infants. A higher number of chronic lifesaving procedures with demonstrated altered stress response patterns were recorded for B/AA preterm infants. This cross-sectional analysis of preterm birth rates and preterm infant developmental and neurodevelopmental outcomes are presented in the context of NICU stress and pain, with attendant implications for infant mortality and future health disparities. Preterm birth rate and outcome inequities further support the need to develop interventions and policies that will reduce the impact of discrimination and improve social determinants of health for Black, Indigenous, and other People of Color.
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影响因子：
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作者：
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通讯作者：
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