College of Veterinary Medicine and Biomedical Science, Texas A&M University, College Station, TX, 77843-4475, USA.
Department of Obstetrics and Gynecology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.
BMC Pregnancy Childbirth. 2020 Mar 12;20(1):155. doi: 10.1186/s12884-020-2847-9.
Despite significant research, the reasons for racial health disparities among adverse birth outcomes (ABO) remain largely unknown. The bulk of research into racial health disparities among ABO in the United States has concentrated on the risk of race and ethnic groups relative to the specific sub-population of non-Hispanic white women and their children. The objective of this study was to estimate the racial and ethnic risks among a set of neonatal and maternal health disparities while minimizing bias attributable to how the baseline risk was established.
All birth records were obtained from the United States Natality database for the years 2014 to 2017. A Bayesian modeling approach was used to estimate the risk disparity for disorders by race. The estimation of the race-specific risks used a sum-to-zero constraint for the race regression coefficients.
Estimating racial health disparities relative to the overall population rate yielded novel results and identified perinatal health disparities for all the race groups studied.
Unbiased risk estimates for racial disparities among ABO are now available for stimulating and initiating more complex causal modeling that can lead to understanding how racial health disparities for ABO are mediated and how they can be prevented.
尽管进行了大量研究，但不良出生结局（ABO）中种族健康差异的原因在很大程度上仍不清楚。美国针对 ABO 中种族健康差异的大部分研究都集中在与特定的非西班牙裔白人妇女及其子女的特定亚人群相比，种族和族裔群体的风险上。本研究的目的是在尽量减少因如何确定基线风险而产生的偏差的情况下，估计一系列新生儿和产妇健康差异中的种族和民族风险。
所有的分娩记录均来自美国 2014 年至 2017 年的出生率数据库。采用贝叶斯建模方法来估计不同种族之间的疾病风险差异。种族特异性风险的估计使用种族回归系数的总和为零的约束条件。
相对于总人口比率来估计种族健康差异，得出了新颖的结果，并确定了所有研究种族群体的围产期健康差异。
现在可以为 ABO 中的种族差异提供无偏风险估计值，以激发和启动更复杂的因果建模，从而了解 ABO 中种族健康差异的中介机制以及如何预防这些差异。
