Division of General Obstetrics and Gynecology, Department of Obstetrics and Gynecology, University of South Florida, Tampa, FL, USA.
Division of General Obstetrics and Gynecology, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
J Racial Ethn Health Disparities. 2021 Feb;8(1):80-87. doi: 10.1007/s40615-020-00759-x. Epub 2020 Apr 24.
Women who are late to prenatal care miss opportunities for health interventions and are at increased risk for pregnancy-related complications. Black women have the lowest rates of first trimester care compared with White or Latinx women. We sought to describe barriers to prenatal care experienced by race/ethnicity in a multi-site, prospective cohort.
We performed a secondary analysis of the Community Child Health Research Network Study, a multi-site prospective cohort study of pregnant women from 2008 to 2012. Women were recruited at the time of delivery and followed prospectively for 2 years. Participants who experienced a repeat pregnancy in the 2-year follow-up period had a prospective assessment of prenatal care barriers. A multilevel mixed effects Poisson regression was performed to evaluate the association between race/ethnicity and number of prenatal barriers.
Of the 298 participants in the sample, 43% of Black, 35% of Latinx, and 23% of White participants reported barriers to prenatal care. After adjustment for confounders, Black and Latinx women reported almost twice as many barriers to prenatal care as White women (adjusted rate ratio 1.89 [1.2, 3.0]; 2.00 [1.1, 3.8], respectively).
In our analysis, multiparous Black and Latinx women reported encountering more barriers to prenatal care than White women. Additional reforms and policy change are needed at the clinic, local, and state levels to support women in accessing early quality prenatal care to achieve racial equity in prenatal care.
错过产前保健的女性会错失健康干预的机会，并增加与妊娠相关的并发症的风险。与白种人或拉丁裔女性相比，黑人女性在孕早期接受护理的比例最低。我们旨在描述在一个多地点、前瞻性队列中按种族/民族划分的产前保健障碍。
我们对社区儿童健康研究网络研究进行了二次分析，该研究是一项针对 2008 年至 2012 年孕妇的多地点前瞻性队列研究。在分娩时招募女性，并进行为期 2 年的前瞻性随访。在 2 年随访期间再次怀孕的参与者进行了前瞻性的产前保健障碍评估。采用多级混合效应泊松回归评估种族/民族与产前障碍数量之间的关联。
在样本的 298 名参与者中，43%的黑人、35%的拉丁裔和 23%的白人参与者报告存在产前保健障碍。在调整混杂因素后，黑人女性和拉丁裔女性报告的产前保健障碍几乎是白人女性的两倍（调整后的比率比 1.89[1.2, 3.0]；2.00[1.1, 3.8]）。
在我们的分析中，多胎黑人女性和拉丁裔女性报告遇到的产前保健障碍比白人女性多。需要在诊所、地方和州各级进行额外的改革和政策变革，以支持妇女获得早期优质产前保健，实现产前保健中的种族平等。
