基于种族的定制对胎儿生长限制的检测的影响
P Ramesh1, L Lemon1, J C Larkin1
1Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
概括
基于种族的胎儿生长标准没有改善胎儿生长限制 (FGR) 的检测. 哈德洛克标准更好地检测黑人新生儿的FGR,而不会对白人新生儿产生负面影响,这表明要远离特定种族的标准来减少差异.
科学领域:
- 产科和妇科
- 产周医学
- 胎儿的发育和成长
背景情况:
- 胎儿生长标准对于诊断胎儿生长限制至关重要,影响胎儿监测决策.
- 由于胎儿和新生儿体重存在种族差异,因此需要对特定种族的胎儿生长曲线进行检查.
- 基于种族的定制对产前FGR检测的影响需要彻底调查以确保公平的护理.
研究的目的:
- 评估基于种族的胎儿生长曲线对FGR产前检测率的影响.
- 为了比较种族定制,非种族定制和哈德洛克胎儿生长标准的诊断性能.
- 根据孕妇的种族和新生儿的妊娠年龄 (SGA) 状态分层分析FGR检测率.
主要方法:
- 在2003年至2013年期间,对8731名 (黑人和白人) 单独生育的回顾性队列研究.
- 使用三个预估胎儿体重 (EFW) 标准进行产前FGR诊断的比较:种族定制 (Cust-Race),非种族定制 (Cust-NoRace) 和哈德洛克.
- 根据母亲的种族和新生儿的分类进行分层分析,分为怀孕年龄 (SGA) (<10个百分点的出生体重).
主要成果:
- 与白人 (6. 8%) 相比,黑人新生儿的妊娠年龄较小 (SGA) 更为常见.
- 与Hadlock标准相比,定制的比赛 (Cust-Race) 标准没有显著改善FGR检测.
- 哈德洛克标准在黑人SGA新生儿中显著更好地检测FGR (44.8%对30.2%),而不会对白人的检测产生负面影响 (52.5%对47.7%).
结论:
- 与哈德洛克标准相比,基于种族的胎儿生长标准没有提高产前FGR检测.
- 哈德洛克标准在识别黑人新生儿的FGR方面似乎更有效,这表明比种族特定的方法有潜在的好处.
- 停止种族特定的生长标准可能是减轻资源分配不平等和减少产科护理的种族差异的策略.
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