在生育能力的种族和民族差异:一个北美预先概念队列研究研究
Lauren A Wise1, Molly N Hoffman1, Sharonda M Lovett1
1Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
Human reproduction (Oxford, England)
|April 17, 2025
概括
在北美,生育能力 (每周期受孕概率) 存在种族和民族差异. 与非西班牙裔白人女性相比,非西班牙裔黑人女性在此预孕队列研究中生育能力明显较低.
科学领域:
- 生殖健康 生殖健康
- 流行病学 流行病学
- 健康差异 在健康上的差异
背景情况:
- 美国先前的研究表明,黑人女性面临更长的等待时间才能接受生育治疗,并且不太可能寻求不育护理.
- 现有的关于生育能力 (每周期受孕概率) 的种族和民族差异研究是有限的,并显示了相互矛盾的结果.
- 了解这些差异对于解决生殖健康不平等至关重要.
研究的目的:
- 调查北美试图怀孕的个人在生育能力方面的种族和种族差异的程度.
- 为了比较不同种族和种族群体的每周期受孕概率.
主要方法:
- 来自在线妊娠研究 (PRESTO) 队列的数据分析,其中包括18,573名21至45岁的美国和加拿大居民,试图在没有生育治疗的情况下怀孕.
- 自我报告的种族和种族数据在入学时收集,每两个月进行长达12个月的随访,以跟踪怀孕状态.
- 使用比例概率回归模型估计生育率 (FRs),对损失后续和子组限制进行敏感性分析.
主要成果:
- 与非西班牙裔白人参与者相比,非西班牙裔黑人参与者表现出明显较低的生育能力 (FR=0.60).
- 在非西班牙裔美国印第安人/阿拉斯加原住民/土著人 (FR=0.70) 和西班牙裔其他/未知种族 (FR=0.77) 群体中也观察到较低的生育能力.
- 与非西班牙裔白人 (16.4%) 相比,非西班牙裔黑人 (33.2%) 和西班牙裔其他/未知种族 (29.7%) 参与者的12周期累计不孕不育率明显高.
结论:
- 在北美预先概念队列中观察到生育能力的显著种族和民族差异.
- 广泛的种族/民族分组可能会掩盖子组内的异质性,并且损失后跟踪引入了潜在的选择偏差.
- 研究结果强调,需要进一步研究推动这些差异的机制,并制定有针对性的计划,以促进生殖健康平等.
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