严重孕产妇发病率的患者和医院水平差异:回顾性多州分析,2015-2020年
Elizabeth Khusid1, Briana Lui1, Virginia E Tangel2
1Weill Cornell Medical College, Weill Cornell Medicine, NY, New York, USA.
Journal of racial and ethnic health disparities
|August 23, 2023
概括
严重的孕产妇发病率 (SMM) 在种族/少数民族中不成比例地增加. 在黑人服务单位独立和互动地分娩增加了SMM几率,突出了在孕产妇医疗保健中持续存在的种族差异.
科学领域:
- 公共卫生 公共卫生
- 孕产妇健康 孕产妇健康
- 健康差异 在健康上的差异
背景情况:
- 在美国 (2018-2020年),严重孕产妇发病率上升了9%,对少数群体产生了不成比例的影响.
- 现有研究表明,医院层面的因素会导致SMM,即使考虑到患者的特征.
- 在高黑人服务单位分娩的女性显示SMM几率增加,表明潜在的系统性问题.
研究的目的:
- 通过检查患者和医院层面的因素来分析SMM的多层次种族/民族差异.
- 研究患者和医院因素对SMM的影响,包括输血.
- 了解种族,种族和分娩单位特征对孕产妇发病率的互动影响.
主要方法:
- 使用2015年至2020年多个州数据的回顾性队列研究.
- 分析了3,497,233次分娩,重点是SMM,SMM不包括输血,仅包括输血.
- 多变量后勤回归模型用于评估影响SMM几率的患者和医院级因素.
主要成果:
- 黑人种族,西班牙裔种族和在黑人服务单位的交付独立地增加了SMM的几率.
- 种族/民族和交付单位类型之间的交互影响进一步增加了SMM风险.
- 仅仅输血与1.30%的分娩有关,而SMM发生在1.63%.
结论:
- 结构性和个人层面的种族/民族差异在母亲的结果仍然存在.
- 在黑人服务单位提供服务加剧了少数民族妇女的SMM风险.
- 多层次的公共政策对于解决和减轻在孕产妇医疗保健中的种族/民族差异至关重要.
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