加强社区doula干预在安全网设置中的有效性:随机对照试验
Julie Mottl-Santiago1, Dmitry Dukhovny2, Howard Cabral3
1Department of Obstetrics and Gynecology, Boston Medical Center, Boston, Massachusetts, USA.
Health equity
|September 21, 2023
概括
社区对杜拉的支持显示,黑人母亲的出生结果有所改善,包括剖腹产减少和母乳养率增加. 需要进一步的研究来证实这些对孕产妇健康公平的好处.
科学领域:
- 孕产妇健康 孕产妇健康
- 健康 公平 卫生 公平
- 公共卫生干预 公共卫生干预
背景情况:
- 孕产妇健康状况的种族差异源于系统性种族主义和社会决定因素.
- 社区杜拉支持,提供情感,教育和宣传服务,是减少这些差异的潜在干预措施.
- 虽然历史上根植于BIPOC社区,但其作为减少差异的临床干预的作用是最近的发展.
研究的目的:
- 测试在医院环境中加强社区杜拉支持的有效性.
- 探索社区杜拉支持与改善出生结果的健康公平之间的关联.
- 分析对剖腹产,早产和母乳养率的影响.
主要方法:
- 一个务实的随机试验,比较标准产妇护理与标准护理以及加强社区doula支持.
- 参与者包括公开资助的健康计划和低风险怀孕的无孕个体.
- 主要结局是剖腹产,次要结局包括早产和母乳养;根据种族-种族进行了分组分析.
主要成果:
- 在初级治疗意图分析中,各组的总体结果相似.
- 观察到增加母乳养开始的趋势 (p=0.08).
- 黑人非西班牙裔参与者显示,剖腹产的绝对减少率为12%,纯母乳养增加了11.5%.
结论:
- 虽然整体研究样本显示了类似的结果,但黑色分娩个体经历了改善的剖腹产和母乳养率.
- 这项研究强调需要进行更大规模的试验,调查社区杜拉对黑人分娩个体的支持.
- 这些发现表明,社区杜拉的支持可能是促进孕产妇健康平等的宝贵工具.
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