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剖腹产的种族差异是由于分娩诱导管理的差异吗?
Rebecca F Hamm1,2, Jennifer A McCoy1, Rebecca R S Clark2,3
1Department of Obstetrics and Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
American journal of perinatology
|February 1, 2024
概括
与白人患者相比,黑人,土著和有色人种 (BIPOC) 患者在分娩诱导期间面临的剖腹产 (CD) 风险比白人患者高40%. 这种差异并不能通过分工诱导管理的差异来解释,这表明其他偏见可能在发挥作用.
科学领域:
- 产科和妇科 产科和妇科
- 健康差距 研究 研究 研究 研究
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 剖腹产 (CD) 率的种族差异是孕产妇医疗保健的一个重大问题.
- 这些差异的确切原因是复杂的和多因素的.
研究的目的:
- 调查劳动诱导 (IOL) 管理的差异是否有助于CD率的种族差异.
- 与白人患者相比,确定导致黑人,土著和有色人种 (BIPOC) 疾病发病率增加的潜在因素.
主要方法:
- 回顾性队列研究的无卵性患者接受IOL为期,单独怀孕.
- 根据自我报告,将患者分为BIPOC或白组.
- 种族群体之间的CD率的比较和IOL管理策略的详细分析.
主要成果:
- 比白人患者 (27.4%) 的BIPOC患者 (72.6%) 更有可能是年轻的和有公共保险的.
- 双重性COPD患者患CD的风险增加了40% (调整后的相对风险=1.41),即使在控制混因子后.
- 在BIPOC和白人患者之间,在CD决定之前,在IOL管理策略 (例如,宫成熟,催产素使用) 中没有发现显著差异.
结论:
- 与白色患者相比,双双眼皮无产妇患者在分娩诱导过程中经历了显著更高的CD率.
- 在CD率中观察到的差异不能归因于分工诱导管理协议的差异.
- 针对超越诱导管理的偏见对于减少剖腹产分娩差异至关重要.
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