Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA.
School of Medicine, Emory University, Atlanta, GA, USA.
Curr Environ Health Rep. 2024 Jun;11(2):279-287. doi: 10.1007/s40572-024-00443-w. Epub 2024 Apr 19.
Although many environmental exposures (e.g., air pollution) are geographically patterned and persist as a result of historic economic policies (e.g., redlining), the impact of reproductive and social policies on maternal and child health remains incompletely understood. Reproductive and social policies are increasingly important for maternal and child health equity, particularly following the 2022 US Supreme Court decision in Dobbs v Jackson Women's Health Organization ("Dobbs decision"), which restricted access to abortion. Here, we summarize the literature from original research studies examining influences of reproductive and social policy on maternal and child health, focusing on impacts on adverse birth outcomes and policies as sources of stress.
Several studies suggest that those most impacted by the Dobbs decision are younger, non-white, socioeconomically disadvantaged, and living in states with less access to government safety net programs, all of which are compounded by environmental injustices. Further, studies conducted in the wake of the Dobbs decision find elevated stress levels among women of reproductive age. This may represent one pathway leading to adverse birth outcomes, as epidemiologic studies demonstrate that preterm birth rates increased following the 2016 election, a period of heightened stress. Reproductive and social policies are understudied contributors to adverse outcomes for reproductive-aged women and their children. This has important implications for maternal and child health equity, as those who will be the most impacted by reproductive and social policies already experience the highest rates of adverse birth outcomes and environmental toxicant exposure.
综述目的：尽管许多环境暴露（例如空气污染）具有地理模式，并由于历史经济政策（例如“红线”政策）而持续存在，但生殖和社会政策对母婴健康的影响仍不完全清楚。生殖和社会政策对于母婴健康公平越来越重要，尤其是在 2022 年美国最高法院在多布斯诉杰克逊妇女健康组织案（“多布斯裁决”）中限制堕胎后。在这里，我们总结了研究生殖和社会政策对母婴健康影响的原始研究文献，重点关注对不良生育结局和政策的影响作为压力源。
最新发现：几项研究表明，受多布斯裁决影响最大的是年轻、非裔美国人、社会经济地位较低的人，以及生活在获得政府安全网计划较少的州，所有这些都因环境不公而加剧。此外，在多布斯裁决之后进行的研究发现，育龄妇女的压力水平升高。这可能是导致不良生育结局的途径之一，因为流行病学研究表明，在 2016 年选举期间，即压力较大的时期，早产率上升。生殖和社会政策是导致育龄妇女及其子女不良结局的研究不足的因素。这对母婴健康公平具有重要意义，因为那些最受生殖和社会政策影响的人已经经历了最高的不良生育结局和环境毒物暴露率。
