Maternal and neonatal health in Canada's Black communities: A scoping review of epidemiologic studies.

Abstract

Objectives: Black-White disparities in maternal and neonatal morbidity and mortality highlight health inequities in several settings, yet such racial disparities in Canada are not well defined. Our objective was to conduct a scoping review to identify the extent of epidemiologic evidence assessing Black-White disparities in maternal and neonatal health in Canada.

Methods: We included peer-reviewed epidemiologic studies which measured maternal or neonatal outcomes in Black versus White individuals in Canada. We searched OVID platforms (MEDLINE, Embase, Emcare) from inception to May 9, 2024, using keywords and controlled vocabulary terms related to race and maternal and neonatal morbidity and mortality. Results synthesis was carried out using descriptive analysis.

Synthesis: After exclusions, six retrospective cohort studies were included in the scoping review. The majority of the included studies used data obtained from provincial datasets (n = 5), defined maternal race using self-reported race (n = 5), and were set in Ontario (n = 4). All studies reported one or more significant associations between race and adverse maternal or neonatal outcomes, with Black individuals experiencing higher rates of spontaneous fetal loss (n = 1), perinatal mortality (n = 1), preterm birth (n = 3), small for gestational age infants (n = 1), low Apgar scores (n = 2), congenital heart disease (n = 1), neonatal intensive care unit admission (n = 1), preeclampsia (n = 2), gestational diabetes (n = 1), and inadequate gestational weight gain (n = 1).

Conclusion: Although literature on the topic is sparse, Black-White disparities in maternal and neonatal health in Canada are apparent. National, population-based data are needed to provide a comprehensive understanding of racial disparities in maternal and neonatal health and the factors driving these differences.