Evaluating the prognostic association between race and perineal trauma: a systematic review protocol

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Epidemiology

Background:

• Perineal trauma affects most women after vaginal delivery, causing significant maternal morbidity.
• While race is considered a risk factor, the roles of racism and social determinants of health remain understudied.
• Understanding these factors is crucial for addressing health disparities in childbirth.

Purpose of the Study:

• To systematically review and synthesize evidence on the prognostic association between race and perineal birth trauma.
• To evaluate the impact of racial status on the incidence and severity of perineal trauma.
• To identify potential contributing factors beyond race, such as social determinants of health.

Main Methods:

• Systematic review and meta-analysis following PRISMA-P and PROGRESS guidelines.
• Searched major databases (PubMed, CINAHL, Web of Science, Embase) for peer-reviewed observational studies.
• Used random-effects models for analysis, assessing risk of bias with ROBINS-I and certainty of evidence with GRADE.

Main Results:

• The review synthesizes existing data on the association between racial status and perineal trauma.
• Analysis will report unadjusted and adjusted risk differences to quantify the association.
• Results will highlight disparities in perineal trauma rates across different racial groups.

Conclusions:

• Race is a significant factor associated with perineal trauma in childbirth.
• Further research is needed to explore the influence of racism and social determinants of health.
• Findings will inform strategies to reduce racial disparities in maternal birth injuries.