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Effects of race and ethnicity on perinatal outcomes in high-income and upper-middle-income countries: an individual participant data meta-analysis of 2 198 655 pregnancies

Allotey, John ; Kew, Tania ; Fernández-Félix, Borja M ; Thangaratinam, Shakila ; Abdollahain, Mali ; Savitri, Ary I. ; Salvesen, Kjell Åsmund ; Bhattacharya, Sohinee ; Olive, Elisa Llurba ; Daskalakis, George ; Macleod, Maureen ; Thilaganathan, Baskaran ; Ramírez, Javier Arenas ; Massé, Jacques ; Magnus, Per Minor ; Sletner, Line ; Baschat, Ahmet ; Ohkuchi, Akihide ; McAuliffe, Fionnuala M. ; West, Jane ; Farrar, Diane ; Riddell, Catherine ; van de Post, Joris ; Illanes, Sebastián E. ; Holzman, Claudia ; van Kuijk, Sander M.J. ; Carbillon, Lionel ; Villa, Pia M. ; Eskild, Anne ; Chappell, Lucy ; Prefumo, Federico ; Seed, Paul ; van Oostwaard, Miriam ; Verlohren, Stefan ; Poston, Lucilla ; Ferrazzi, Enrico ; Vinter, Christina A. ; Nagata, Chie ; Brown, Mark ; Vollebregt, Karlijn C. ; Takeda, Satoru ; Langenveld, Josje ; Widmer, Mariana ; Haavaldsen, Camilla ; Olsen, Jørn ; Wolf, Hans ; Zavaleta, Nelly ; Lumbiganon, Pisake ; Sequeira, Evan ; Gibson, Robert ; Ferrazzani, Sergio ; Frusca, Tiziana ; Figueiró-Filho, Ernesto A. ; Lapaire, Olav ; Laivuori, Hannele ; Conde-Agudelo, Agustin ; Galindo, Alberto ; Mbah, Alfred ; Herraiz, Ignacio ; Trogstad, Lill ; Steegers, Eric A.P. ; Salim, Read ; Huang, Tianhua ; Adank, Annemarijne ; Meschino, Wendy S. ; Browne, Joyce L. ; Da Silva Costa, Fabricio ; Jørgensen, Jan Stener ; Forest, Jean-Claude ; Rumbold, Alice R. ; Mol, Ben W. ; Giguère, Yves ; Ganzevoort, Wessel ; Odibo, Anthony O. ; Myers, Jenny ; Teede, Helena J. ; Goffinet, Francois ; McCowan, Lesley ; Pajkrt, Eva ; Dekker, Gustaaf ; Kleinrouweler, Emily C. ; Roberts, Claire T. ; Groen, Henk ; Skråstad, Ragnhild Bergene ; Heinonen, Seppo ; Eero, Kajantie ; Kenny, Louise C. ; Souka, Athena ; Monterio, Ilza ; Coomarasamy, Arri ; Smuk, Melanie ; Pillalis, Athanasios ; Crovetto, Francesca ; Ann Hawkins, Lee ; Gabbay- Benziv, Rinat ; Riley, Richard ; Snell, Kym ; Archer, Lucinda ; Figuera, Francesc ; van Gelder, Marleen

The Lancet (British edition), 2022-12, Vol.400 (10368), p.2049-2062 [Periódico revisado por pares]

England: Elsevier Ltd

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Título:
Effects of race and ethnicity on perinatal outcomes in high-income and upper-middle-income countries: an individual participant data meta-analysis of 2 198 655 pregnancies
Autor: Allotey, John ; Kew, Tania ; Fernández-Félix, Borja M ; Thangaratinam, Shakila ; Abdollahain, Mali ; Savitri, Ary I. ; Salvesen, Kjell Åsmund ; Bhattacharya, Sohinee ; Olive, Elisa Llurba ; Daskalakis, George ; Macleod, Maureen ; Thilaganathan, Baskaran ; Ramírez, Javier Arenas ; Massé, Jacques ; Magnus, Per Minor ; Sletner, Line ; Baschat, Ahmet ; Ohkuchi, Akihide ; McAuliffe, Fionnuala M. ; West, Jane ; Farrar, Diane ; Riddell, Catherine ; van de Post, Joris ; Illanes, Sebastián E. ; Holzman, Claudia ; van Kuijk, Sander M.J. ; Carbillon, Lionel ; Villa, Pia M. ; Eskild, Anne ; Chappell, Lucy ; Prefumo, Federico ; Seed, Paul ; van Oostwaard, Miriam ; Verlohren, Stefan ; Poston, Lucilla ; Ferrazzi, Enrico ; Vinter, Christina A. ; Nagata, Chie ; Brown, Mark ; Vollebregt, Karlijn C. ; Takeda, Satoru ; Langenveld, Josje ; Widmer, Mariana ; Haavaldsen, Camilla ; Olsen, Jørn ; Wolf, Hans ; Zavaleta, Nelly ; Lumbiganon, Pisake ; Sequeira, Evan ; Gibson, Robert ; Ferrazzani, Sergio ; Frusca, Tiziana ; Figueiró-Filho, Ernesto A. ; Lapaire, Olav ; Laivuori, Hannele ; Conde-Agudelo, Agustin ; Galindo, Alberto ; Mbah, Alfred ; Herraiz, Ignacio ; Trogstad, Lill ; Steegers, Eric A.P. ; Salim, Read ; Huang, Tianhua ; Adank, Annemarijne ; Meschino, Wendy S. ; Browne, Joyce L. ; Da Silva Costa, Fabricio ; Jørgensen, Jan Stener ; Forest, Jean-Claude ; Rumbold, Alice R. ; Mol, Ben W. ; Giguère, Yves ; Ganzevoort, Wessel ; Odibo, Anthony O. ; Myers, Jenny ; Teede, Helena J. ; Goffinet, Francois ; McCowan, Lesley ; Pajkrt, Eva ; Dekker, Gustaaf ; Kleinrouweler, Emily C. ; Roberts, Claire T. ; Groen, Henk ; Skråstad, Ragnhild Bergene ; Heinonen, Seppo ; Eero, Kajantie ; Kenny, Louise C. ; Souka, Athena ; Monterio, Ilza ; Coomarasamy, Arri ; Smuk, Melanie ; Pillalis, Athanasios ; Crovetto, Francesca ; Ann Hawkins, Lee ; Gabbay- Benziv, Rinat ; Riley, Richard ; Snell, Kym ; Archer, Lucinda ; Figuera, Francesc ; van Gelder, Marleen
Assuntos: Age ; Babies ; Bias ; Birth ; Birth weight ; Black people ; Citation indexes ; Clinical trials ; Complications ; Data analysis ; Datasets ; Death ; Developing Countries ; Ethnicity ; Female ; Fetal Growth Retardation ; Health risks ; High income ; Hispanic people ; Humans ; Income ; Infant ; Infant mortality ; Infant, Newborn ; Meta-analysis ; Minority & ethnic groups ; Neonates ; Parent educational background ; Perinatal Death ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome - epidemiology ; Premature birth ; Premature Birth - epidemiology ; Race ; Racial identity ; Regression models ; Risk ; Small for gestational age ; Stillbirth ; Stillbirth - epidemiology ; Subgroups ; White people ; Womens health
É parte de: The Lancet (British edition), 2022-12, Vol.400 (10368), p.2049-2062
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
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Descrição: Existing evidence on the effects of race and ethnicity on pregnancy outcomes is restricted to individual studies done within specific countries and health systems. We aimed to assess the impact of race and ethnicity on perinatal outcomes in high-income and upper-middle-income countries, and to ascertain whether the magnitude of disparities, if any, varied across geographical regions. For this individual participant data (IPD) meta-analysis we used data from the International Prediction of Pregnancy Complications (IPPIC) Network of studies on pregnancy complications; the full dataset comprised 94 studies, 53 countries, and 4 539 640 pregnancies. We included studies that reported perinatal outcomes (neonatal death, stillbirth, preterm birth, and small-for-gestational-age babies) in at least two racial or ethnic groups (White, Black, south Asian, Hispanic, or other). For our two-step random-effects IPD meta-analysis, we did multiple imputations for confounder variables (maternal age, BMI, parity, and level of maternal education) selected with a directed acyclic graph. The primary outcomes were neonatal mortality and stillbirth. Secondary outcomes were preterm birth and a small-for-gestational-age baby. We estimated the association of race and ethnicity with perinatal outcomes using a multivariate logistic regression model and reported this association with odds ratios (ORs) and 95% CIs. We also did a subgroup analysis of studies by geographical region. 51 studies from 20 high-income and upper-middle-income countries, comprising 2 198 655 pregnancies, were eligible for inclusion in this IPD meta-analysis. Neonatal death was twice as likely in babies born to Black women than in babies born to White women (OR 2·00, 95% CI 1·44–2·78), as was stillbirth (2·16, 1·46–3·19), and babies born to Black women were at increased risk of preterm birth (1·65, 1·46–1·88) and being small for gestational age (1·39, 1·13–1·72). Babies of women categorised as Hispanic had a three-times increased risk of neonatal death (OR 3·34, 95% CI 2·77–4·02) than did those born to White women, and those born to south Asian women were at increased risk of preterm birth (OR 1·26, 95% CI 1·07–1·48) and being small for gestational age (1·61, 1·32–1·95). The effects of race and ethnicity on preterm birth and small-for-gestational-age babies did not vary across regions. Globally, among underserved groups, babies born to Black women had consistently poorer perinatal outcomes than White women after adjusting for maternal characteristics, although the risks varied for other groups. The effects of race and ethnicity on adverse perinatal outcomes did not vary by region. National Institute for Health and Care Research, Wellbeing of Women.
Editor: England: Elsevier Ltd
Idioma: Inglês;Norueguês

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Effects of race and ethnicity on perinatal outcomes in high-income and upper-middle-income countries: an individual participant data meta-analysis of 2 198 655 pregnancies

England: Elsevier Ltd

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