审视种族在佛罗里达州孕产妇发病率及不良婴儿出生结局中的作用(2004年至2022年)——一项回顾性探索性分析

Examining the Role of Race in Maternal Morbidities and Adverse Infant Birth Outcomes in Florida (2004 to 2022) - A Retrospective Exploratory Analysis.

作者信息

Parra Alexa, Balise Raymond, Morales Vanessa, Lebron Cynthia N, Pan Yue, Potter JoNell, Santos Hudson P

机构信息

School of Nursing and Health Studies, University of Miami, 5030 Brunson Dr, Coral Gables, FL, 33146, USA.

Miller School of Medicine, Department of Public Health, University of Miami, 1120 NW 14Th St, Miami, FL, 33136, USA.

出版信息

J Racial Ethn Health Disparities. 2025 Aug 13. doi: 10.1007/s40615-025-02599-z.

Abstract

BACKGROUND

Studies reporting maternal morbidities and adverse infant outcomes group Hispanics together without considering the implications of racial identity, particularly among Black Hispanics in the United States.

OBJECTIVE

This study aims to examine maternal morbidity and adverse infant birth outcomes across racially and ethnically diverse groups in Florida (from 2004-2022), with particular attention to the heterogeneity within the Hispanic population.

METHODS

We conducted a retrospective secondary analysis of Florida birth certificate data from 2004 to 2022 (N = 3,364,973), examining maternal morbidity (hypertensive disorders in pregnancy, gestational diabetes) and adverse infant outcomes (preterm birth, small or large for gestational age). Outcomes were stratified by race and ethnicity. Logistic regression models were employed to estimate crude and adjusted odds ratios while controlling for key sociodemographic covariates.

RESULTS

Black Hispanic mothers had higher odds of hypertensive disorders in pregnancy, but no significant difference in gestational diabetes after considering the independent impact of race and ethnicity. Their infants had lower odds of preterm birth and small-for-gestational-age, and higher odds of large-for-gestational-age after considering the independent impact of race and ethnicity. Compared to other groups, Black Hispanics had the lowest rates of private insurance, educational attainment, and prenatal care adequacy, highlighting sociodemographic disparities alongside clinical outcomes.

CONCLUSION

Our findings highlight nuanced disparities in maternal and infant outcomes for Black Hispanics. Further investigation is essential to understand why maternal health outcomes for Black Hispanics align more closely with their Black counterparts, while infant outcomes diverge, emphasizing the need for disaggregated analyses within the Hispanic population.

摘要

背景

报告孕产妇发病率和不良婴儿结局的研究将西班牙裔归为一类,而未考虑种族身份的影响,尤其是在美国的黑人西班牙裔群体中。

目的

本研究旨在调查佛罗里达州不同种族和族裔群体(2004年至2022年)的孕产妇发病率和不良婴儿出生结局,特别关注西班牙裔人群内部的异质性。

方法

我们对2004年至2022年佛罗里达州出生证明数据进行了回顾性二次分析(N = 3,364,973),研究孕产妇发病率(妊娠高血压疾病、妊娠期糖尿病)和不良婴儿结局(早产、小于或大于胎龄)。结局按种族和族裔分层。采用逻辑回归模型估计粗比值比和调整后的比值比,同时控制关键的社会人口统计学协变量。

结果

考虑种族和族裔的独立影响后,黑人西班牙裔母亲患妊娠高血压疾病的几率较高,但妊娠期糖尿病无显著差异。考虑种族和族裔的独立影响后,她们的婴儿早产和小于胎龄的几率较低,大于胎龄的几率较高。与其他群体相比,黑人西班牙裔的私人保险覆盖率、教育程度和产前护理充足率最低,突出了社会人口统计学差异以及临床结局。

结论

我们的研究结果突出了黑人西班牙裔在母婴结局方面的细微差异。进一步调查对于理解为什么黑人西班牙裔的孕产妇健康结局与其黑人同胞更为接近,而婴儿结局却有所不同至关重要,强调了对西班牙裔人群进行分类分析的必要性。

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