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交织的不平等:应用母婴对子视角推进围产期健康公平。

Intertwined disparities: Applying the maternal-infant dyad lens to advance perinatal health equity.

机构信息

Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States.

Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, F-75004 Paris, France.

出版信息

Semin Perinatol. 2021 Jun;45(4):151410. doi: 10.1016/j.semperi.2021.151410. Epub 2021 Mar 21.

Abstract

Differences in the quality of delivery hospital care contribute to persistent, intertwined racial and ethnic disparities in both maternal and infant health. Despite the shared causal pathways and overlapping burden of maternal and infant health disparities, little research on perinatal quality of care has addressed obstetric and neonatal care jointly to improve outcomes and reduce health inequities for the maternal-infant dyad. In this paper, we review the role of hospital quality in shaping perinatal health outcomes, and investigate how a framework that considers the mother-infant dyad can enhance our understanding of the full burden of obstetric and neonatal disparities on health and society. We conclude with a discussion of how integrating a maternal-infant dyad lens into research and clinical intervention to improve quality of care can move the needle on disparity reduction for both women and infants around the time of birth and throughout the life course.

摘要

分娩医院护理质量的差异导致了孕产妇和婴儿健康方面持续存在的、相互交织的种族和民族差异。尽管孕产妇和婴儿健康差异具有共同的因果途径和重叠的负担,但很少有关于围产期护理质量的研究将产科和新生儿护理结合起来,以改善母婴对子的结局并减少健康不平等。在本文中,我们回顾了医院质量在塑造围产期健康结局中的作用,并探讨了考虑母婴对子的框架如何增强我们对产科和新生儿差异对健康和社会的全部负担的理解。最后,我们讨论了如何将母婴对子的视角纳入研究和临床干预中,以改善护理质量,从而在分娩前后和整个生命过程中减少妇女和婴儿的差异。

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