Chaudhary Neha, Meharwal Arushi
Department of Pediatrics, Tufts University School of Medicine, Boston, MA, United States.
BS Biology, College of Science, Northeastern University, Boston, MA, United States.
Front Pediatr. 2024 Oct 1;12:1378370. doi: 10.3389/fped.2024.1378370. eCollection 2024.
Neonatal outcomes encompass a range of outcome measures, including mortality rates, physical and mental health morbidities, and long-term neurodevelopmental statistics. These outcomes are influenced by non-modifiable factors, such as sex and race, and modifiable factors, such as social determinants of health and racism. There is a known bias toward worse outcomes for male infants in terms of preterm birth, low birth weight, and mortality, with several biological and physiological factors contributing to these sex-related differences. In relation to racial disparities, wherein race is a social construct, maternal and infant healthcare continues to lag behind for minority populations compared with the white population, despite advances in medical care. Infants born to Black women have higher infant mortality rates and lower birth weights than infants of white women. These differences can be largely attributed to social and environmental factors, rather than racial and ethnic differences. Furthermore, we emphasize the role of social determinants of health in neonatal outcomes. Factors such as economic stability, education access and quality, healthcare access and quality, the physical neighborhood environment, and the social and community context all contribute to these outcomes. Overall, this article highlights the complex interactions between sex, race(ism), and social determinants of health in neonatal outcomes. It underscores the need for a comprehensive understanding of these factors to improve maternal-neonatal care and reduce disparities in outcomes. Healthcare providers, policymakers, and communities need to work together to combat these complex issues and improve neonatal outcomes for all infants, while understanding the complex interplay between sex, racism, and/or social determinants of health.
新生儿结局涵盖一系列结局指标，包括死亡率、身心健康发病率以及长期神经发育统计数据。这些结局受到不可改变的因素影响，如性别和种族，以及可改变的因素影响，如健康的社会决定因素和种族主义。已知在早产、低出生体重和死亡率方面男婴的结局更差，有几个生物学和生理学因素导致了这些与性别相关的差异。关于种族差异，种族是一种社会建构，尽管医疗有所进步，但与白人相比，少数族裔人群的母婴保健仍落后。黑人女性所生婴儿的死亡率高于白人女性所生婴儿，出生体重也更低。这些差异在很大程度上可归因于社会和环境因素，而非种族和民族差异。此外，我们强调健康的社会决定因素在新生儿结局中的作用。经济稳定性、教育机会和质量、医疗保健机会和质量、周边物质环境以及社会和社区环境等因素都对这些结局有影响。总体而言，本文强调了性别、种族（主义）和健康的社会决定因素在新生儿结局中的复杂相互作用。它强调需要全面理解这些因素，以改善母婴保健并减少结局差异。医疗保健提供者、政策制定者和社区需要共同努力应对这些复杂问题，改善所有婴儿的新生儿结局，同时理解性别、种族主义和/或健康的社会决定因素之间的复杂相互作用。
