Department of Obstetrics and Gynecology, Boston University Medical Center, Boston University School of Medicine, 85 E Concord St, 6th Floor, Boston, MA 02118.
Department of Obstetrics and Gynecology, Boston University Medical Center, Boston University School of Medicine, 85 E Concord St, 6th Floor, Boston, MA 02118.
Semin Perinatol. 2017 Aug;41(5):308-317. doi: 10.1053/j.semperi.2017.04.008. Epub 2017 Jul 29.
Rates of maternal morbidity and mortality are rising in the United States. Non-Hispanic Black women are at highest risk for these outcomes compared to those of other race/ethnicities. Black women are also more likely to be late to prenatal care or be inadequate users of prenatal care. Prenatal care can engage those at risk and potentially influence perinatal outcomes but further research on the link between prenatal care and maternal outcomes is needed. The objective of this article is to review literature illuminating the relationship between prenatal care utilization, social determinants of health, and racial disparities in maternal outcome. We present a theoretical framework connecting the complex factors that may link race, social context, prenatal care utilization, and maternal morbidity/mortality. Prenatal care innovations showing potential to engage with the social determinants of maternal health and address disparities and priorities for future research are reviewed.
美国的产妇发病率和死亡率正在上升。与其他种族/族裔相比,非西班牙裔黑人妇女面临这些后果的风险最高。黑人妇女也更有可能延迟接受产前护理或无法充分利用产前护理。产前护理可以接触到那些有风险的人,并可能影响围产期结局,但需要进一步研究产前护理与产妇结局之间的联系。本文的目的是回顾文献,阐明产前护理利用、健康的社会决定因素与产妇结局的种族差异之间的关系。我们提出了一个理论框架,将可能与种族、社会背景、产前护理利用以及产妇发病率/死亡率相关的复杂因素联系起来。我们还回顾了具有潜力的产前护理创新,以解决与产妇健康的社会决定因素相关的问题,并解决差距和未来研究的重点。