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Racial inequality in perinatal outcomes in two Brazilian birth cohorts

J M Fonseca1, A A M Silva1, P R H Rocha2

  • 1Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil.

Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Medicas E Biologicas
|January 27, 2021
PubMed

Insights

Racial inequality in birth outcomes like low birth weight (LBW) and intrauterine growth restriction (IUGR) was found in Ribeirão Preto, Brazil, but not in São Luís. This suggests racial discrimination may impact infant health differently across Brazilian cities.

Area of Science:

  • Public Health
  • Epidemiology
  • Social Determinants of Health

Background:

  • Racial disparities in perinatal outcomes are a significant global health concern.
  • Understanding the influence of socioeconomic and biological factors on these disparities is crucial for targeted interventions.
  • Brazil's diverse population presents a unique context for studying racial inequality in maternal and child health.

Purpose of the Study:

  • To estimate and compare racial inequality in low birth weight (LBW), preterm birth (PTB), and intrauterine growth restriction (IUGR).
  • To investigate these disparities within two distinct Brazilian birth cohorts: Ribeirão Preto (RP) and São Luís (SL).
  • To assess the impact of adjusted socioeconomic and biological covariates on observed racial inequalities in perinatal outcomes.

Main Methods:

  • Cross-sectional study nested within two Brazilian birth cohorts (RP and SL) with data collected from 2010.
  • Maternal skin color was the primary exposure variable.
  • Statistical analysis involved chi-squared tests and logistic regression, adjusting for multiple socioeconomic and biological factors.

Main Results:

  • In Ribeirão Preto, mothers with black skin color had a significantly higher risk of LBW and IUGR, even after adjustments.
  • In São Luís, maternal skin color was not identified as a risk factor for LBW, PTB, or IUGR, before or after adjustments.
  • The findings suggest that racial discrimination may be a contributing factor to observed health disparities in Ribeirão Preto.

Conclusions:

  • Racial inequality in specific perinatal outcomes (LBW, IUGR) was detected in the Ribeirão Preto cohort, but not in the São Luís cohort.
  • The results highlight the potential role of societal racial discrimination in influencing health outcomes.
  • Greater miscegenation in São Luís might be associated with reduced racial discrimination against Black and Brown women, potentially explaining the absence of disparities in that cohort.

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