Racism linked to pregnancy outcomes in analysis

Racism may be a key factor in poor pregnancy outcomes, researchers say today.

In previous work, racial discrimination is consistently linked to a range of health outcomes and disparities, say Dr Kim Robin van Daalen of Cambridge University, UK, and colleagues in today’s BMJ Global Health.

The authors report that upstream social, environmental, economic and political factors are fundamental drivers of health inequities.

They carried out a systematic review and meta-analysis on self-reported racial discrimination and adverse pregnancy outcomes, using 24 reliable studies. Most were based in the USA.

Looking at all outcomes together, each of the studies found a significant link between experiencing racial discrimination and risk of an adverse pregnancy event.

The risk for preterm birth was raised by 40%, and the risk of a small for gestational age baby was 23% higher.

The authors believe that, as racial or ethnic disparities worsen or persist in foetal, neonatal and maternal health outcomes, "it is pertinent to identify and address the underlying causal and mediating factors".

They conclude: "These results suggest that racial discrimination has adverse impacts on pregnancy outcomes. This is supported by the broader literature on racial discrimination as a risk factor for adverse health outcomes."

They call for a further exploration of this link and its underlying mechanisms, including mediating and moderating factors, as well as higher quality evidence from large ethnographically diverse groups.

van Daalen, K. R. et al. Racial discrimination and adverse pregnancy outcomes: a systematic review and meta-analysis. BMJ Global Health 3 August 2022; doi: 10.1136/bmjgh-2022-009227


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