臂丛出生损伤的种族差异是否可以用已知的危险因素来解释？

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2025-03-15 DOI:10.1038/s41372-025-02239-8

M Claire Manske, Machelle D Wilson, Barton L Wise, Herman L Hedriana, Joy Melnikow, Daniel J Tancredi

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引用次数: 0

摘要

目的：探讨母亲种族/民族与臂丛出生损伤（BPBI）危险因素的关系，并量化这些因素导致的过量BPBI风险比例。研究设计：这项回顾性队列研究纳入了1996-2012年在加州许可医院发生的所有活产婴儿，包括6,278,562对产妇和活产婴儿，其中7762例诊断为BPBI。采用多元逻辑回归和因果中介分析来评估种族/民族与BPBI危险因素的关系。结果：黑人和西班牙裔出生个体的肥胖、糖尿病和有限的产前护理利用风险增加，但许多BPBI危险因素（肩难产、巨大儿、第二产程延长和阴道分娩）的风险降低。结论：黑人和西班牙裔出生个体在许多强烈相关的BPBI风险因素中风险较低，这些因素仅占其过量BPBI风险的一小部分，强调了识别其他风险因素的重要性，特别是人口差异的驱动因素。

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Are racial and ethnic disparities in brachial plexus birth injuries explained by known risk factors?

Objective: To investigate the association of maternal race/ethnicity with risk factors for brachial plexus birth injury (BPBI) and quantify the proportion of excess BPBI risk due to these factors.

Study design: This retrospective cohort study of all livebirths occurring in California-licensed hospitals from 1996-2012 included 6,278,562 maternal-livebirth infant pairs with 7762 BPBI diagnoses. Multiple logistic regression and causal mediation analyses were used to evaluate the relationship of race/ethnicity and BPBI risk factors.

Results: Black and Hispanic birthing-individuals were at increased risk of obesity, diabetes, and limited prenatal care utilization but decreased risk of many BPBI risk factors (shoulder dystocia, macrosomia, prolonged second stage of labor, and vaginal delivery).

Conclusions: Black and Hispanic birthing-individuals were at lower risk of many strongly associated risk factors for BPBI, and these factors mediate only a small proportion of their excess BPBI risk, underscoring the importance of identifying alternative risk factors, especially drivers of demographic disparities.

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.