Beldon Marissa A, Clay Shondra L, Uhr Stephanie D, Woolfolk Candice L, Canton Imani J
National Center for Women and IT, University of Colorado, Boulder, CO, USA.
College of Health and Human Sciences, Northern Illinois University, DeKalb, IL, USA.
J Immigr Minor Health. 2025 Feb;27(1):149-170. doi: 10.1007/s10903-024-01641-2. Epub 2024 Oct 31.
Research suggests that stress due to racism may underlie the disproportionately high rates of adverse pregnancy outcomes experienced by Black women in the US. Study objectives: (1) Identify forms of systemic racism affecting pregnancy outcomes and (2) increase understanding about the role of racism in adverse pregnancy outcomes for Black women. A systematic review was conducted to explore the relationship between systemic racism and pregnancy outcomes for Black women. Searches were performed using EBSCO Academic Search Complete, CINAHL Complete, and Consumer Health Complete first between January to April 2021 and subsequently between November 2023 to January 2024. Included studies were observational, written in English, had full-text availability, examined at least one form of systemic racism and pregnancy outcome, and reported results for Black women. A meta-analysis was performed using a random effects model, summary effect estimates were pooled by pregnancy outcome. The I statistic was used to measure heterogeneity between studies. A total of 32 studies were included in the review. Significant pooled effects of exposure to systemic racism were observed for preterm birth 0.30 (95% CI 0.12-0.48), small for gestational age 0.31 (95% CI 0.05-0.58), and low birth weight 0.24 (95% CI 0.11-0.37). Among studies that compared results by race, exposure to systemic racism had a significant and rather large effect on preterm birth for Black women (d = 0.62; 95% CI 0.06-0.41). Exposure to systemic racism has a significant effect on preterm birth, small for gestational age, and low birth weight for Black women. Having knowledge of how racism contributes to stress and poor pregnancy outcomes can help health professionals improve delivery of quality care to Black women. Future research should continue identifying forms of racism positively related to adverse pregnancy outcomes.
研究表明，种族主义导致的压力可能是美国黑人女性不良妊娠结局比例过高的潜在原因。研究目标：（1）确定影响妊娠结局的系统性种族主义形式；（2）增进对种族主义在黑人女性不良妊娠结局中所起作用的理解。进行了一项系统综述，以探讨系统性种族主义与黑人女性妊娠结局之间的关系。检索首先在2021年1月至4月期间使用EBSCO学术搜索完整版、护理学与健康领域数据库完整版和消费者健康完整版进行，随后在2023年11月至2024年1月期间进行。纳入的研究为观察性研究，用英文撰写，有全文可供获取，研究了至少一种系统性种族主义形式和妊娠结局，并报告了黑人女性的结果。使用随机效应模型进行荟萃分析，汇总效应估计值按妊娠结局进行合并。I统计量用于衡量研究之间的异质性。该综述共纳入32项研究。观察到暴露于系统性种族主义对早产的显著合并效应为0.30（95%置信区间0.12 - 0.48），小于胎龄儿为0.31（95%置信区间0.05 - 0.58），低出生体重为0.24（95%置信区间0.11 - 0.37）。在按种族比较结果的研究中，暴露于系统性种族主义对黑人女性早产有显著且相当大的影响（d = 0.62；95%置信区间0.06 - 0.41）。暴露于系统性种族主义对黑人女性的早产、小于胎龄儿和低出生体重有显著影响。了解种族主义如何导致压力和不良妊娠结局有助于医疗专业人员改善对黑人女性的优质护理。未来的研究应继续确定与不良妊娠结局呈正相关的种族主义形式。
