非西班牙裔黑人个人中早产的社会决定因素
Diane N Fru1, Elizabeth Kelly1,2, Matthew Orischak1
1Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio.
American journal of perinatology
|September 24, 2024
概括
早产 (PTB) 显著影响黑人个体. 健康的社会决定因素,如缺乏产前护理和教育,与PTB风险有很强的相关性,突出了婴儿死亡率的差异.
科学领域:
- 公共卫生 公共卫生
- 社会学 社会学 社会学
- 生殖健康 生殖健康
背景情况:
- 在美国,非西班牙裔黑人个体的早产率 (PTB) 不成比例地高.
- PTB是导致婴儿死亡率种族差异的主要原因之一.
- 健康社会决定因素 (SDoH) 是影响健康结果的关键因素.
研究的目的:
- 在非西班牙裔黑人中确定与PTB相关的特定SDoH指标.
- 量化各种SDoH因素与PTB风险之间的关联.
- 为旨在减少PTB种族差异的干预提供信息.
主要方法:
- 一项回顾性病例对照研究,利用2012-2016年美国出生记录.
- 在非西班牙裔黑人未满期 (<37周) 和满期 (≥37周) 的单人活产之间比较SDoH指标.
- 后勤回归分析用于计算SDoH与PTB的关联的几率比率 (OR) 和95%置信区间 (CI).
主要成果:
- 确定了关键的PTB风险因素:没有/不足的产前护理 (OR 3.0/2.7),怀孕期间吸烟 (OR 1.4),未婚状态 (OR 1.18),缺乏高中文凭 (OR 1.1),以及黑人父亲种族 (OR 1.10).
- 出生证明上没有父亲的名字也与增加PTB风险有关 (OR 1.22).
- 获得WIC (妇女,婴儿和儿童) 福利显示有保护作用 (OR 0.83).
结论:
- 先进的母亲年龄 (≥35),吸烟,医疗补助使用,低学历,未婚状态,不充分的产前护理和特定的父亲因素增加了黑人中PTB风险.
- 了解这些SDoH指标对于制定有针对性的干预措施至关重要.
- 解决SDoH可以帮助减轻早产率的种族差异.
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