Primary Care Physician Assistant Program, Keck School of Medicine, University of Southern California, Alhambra, CA, USA.
Womens Health (Lond). 2021 Jan-Dec;17:17455065211019888. doi: 10.1177/17455065211019888.
While the rate of pregnancy-related death steadily increases in the United States, this tragic outcome is disproportionately devastating US-born non-Hispanic Black women at a rate that is three to four times that of their White and non-Black Hispanic counterparts. These disparities persist despite controlling for variables such as socioeconomic status, education levels, and geographical location. Pregnancy-related deaths in Black women are largely cardiovascular in etiology, and while these complications also occur in women of other ethnic backgrounds, they often are more severe and more deadly in Black women. This population often lacks adequate prenatal care likely because they face personal and structural barriers. Reversal of barriers during the prenatal period, the implementation of medical protocols during delivery, and the assurance of close follow-up during the postpartum year are vital in improving outcomes. This article will detail seven specific concerns within perinatal care and pregnancy-related death, and offer potential solutions to addressing them. Pregnancy-related death in Black women is not as an isolated event, but rather is one adverse outcome that exists on a broad spectrum of adverse outcomes. Now is the time to reckon with the reality that our nation's Black women are dying at a disproportionate rate compared to women of other ethnicities due to pregnancy-related complications and suffering lifelong consequences even if they escape this fatal outcome. This is a call to action to understand this deeply devastating, multi-factorial issue so we may strive to eliminate this highly preventable and tragic event altogether.
虽然美国的妊娠相关死亡率稳步上升，但这种悲惨的结果对美国本土非西班牙裔黑人女性的影响不成比例，其死亡率是白人女性和非裔西班牙裔女性的三到四倍。尽管控制了社会经济地位、教育水平和地理位置等变量，但这些差异仍然存在。黑人女性的妊娠相关死亡主要与心血管病因有关，虽然这些并发症也发生在其他族裔背景的女性中，但在黑人女性中往往更为严重和致命。这些人群往往缺乏足够的产前保健，可能是因为她们面临个人和结构性障碍。在产前期间消除障碍、在分娩期间实施医疗方案以及在产后一年内确保密切随访，对于改善结果至关重要。本文将详细介绍围产期护理和妊娠相关死亡中的七个具体问题，并提供解决这些问题的潜在方法。黑人女性的妊娠相关死亡不是孤立的事件，而是广泛的不良后果之一。现在是正视现实的时候了，由于妊娠相关并发症，我国的黑人女性的死亡率不成比例地高于其他族裔的女性，即使她们逃过了这种致命的结果，也会遭受终身的后果。这是一项采取行动的呼吁，旨在了解这一深刻的破坏性、多因素问题，以便我们能够努力完全消除这种高度可预防和悲惨的事件。
