生殖内分泌学和不孕症的种族和民族差异的系统回顾:我们今天站在哪里?

Tia Jackson-Bey M.D., M.P.H. , Jerrine Morris M.D., M.P.H. , Elizabeth Jasper Ph.D. , Digna R. Velez Edwards Ph.D., M.S. , Kim Thornton M.D. , Gloria Richard-Davis M.D. , Torie Comeaux Plowden M.D., M.P.H.
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引用次数: 14

摘要

目的对不孕症护理和治疗中的种族和民族健康差异进行全面回顾。证据回顾从建立到2021年4月,在PubMed和Embase中进行了系统的文献检索。如果研究是在人类中进行的原始研究,观察性研究设计,关注导致不孕症的情况,获得不孕症护理或不孕症治疗的结果,并提供有关种族或民族群体的相关信息,则有资格纳入研究。标题和摘要由两名审稿人独立审查,以确定相关文章。此外,对纳入文章的参考文献进行筛选。结果PubMed检索产生2,113篇文章。在Embase搜索中发现了另外2301篇文章。总共筛选了4,414篇文章,并在必要时加上摘要。34例符合纳入标准,纳入本综述。从纳入文献的参考文献中检索到另外3项研究,共37篇可供讨论:26篇回顾性队列研究,2篇前瞻性队列研究,9篇横断面研究。文献中的总体共识是,基于种族和民族的生殖健康差异影响生育率、获得护理的机会和生育治疗的结果。结论(s)在获得全方位生殖护理(包括不孕症评估和治疗)方面,种族和民族差异仍然存在。尽管可以获得不孕症治疗,但治疗结果仍然存在差异。内在和外在因素,如种族主义的制度化和医学中的歧视,仍然影响着不孕症患者的诊断、护理和治疗结果。为了解决这些不公平现象,我们应该减轻提供者的偏见,资助高质量的健康差异研究,提高患者的生殖健康知识,并倡导增加所有人获得治疗的机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Systematic review of racial and ethnic disparities in reproductive endocrinology and infertility: where do we stand today?

Objective

To conduct a comprehensive review of racial and ethnic health disparities in infertility care and treatment.

Evidence Review

Systematic literature searches were performed in PubMed and Embase from inception to April 2021. Studies were eligible for inclusion if they were original research performed in humans, observational study design, focused on circumstances contributing to infertility, access to infertility care, or outcomes of infertility treatment, and provided relevant information on racial or ethnic groups. Titles and abstracts were reviewed independently by two reviewers to identify pertinent articles. In addition, references of included articles were screened.

Result(s)

The PubMed search yielded 2,113 articles. An additional 2,301 articles were found in the Embase search. In total, 4,414 articles were screened on the basis of title and, where necessary, abstract. Thirty-four were found to meet the inclusion criteria and included in this review. Three additional studies were found from searching references of the included articles, resulting in 37 articles for discussion: 26 retrospective cohort studies, 2 prospective cohort studies, and 9 cross-sectional studies. The overall consensus in the literature is that reproductive health disparities on the basis of race and ethnicity impact fertility, access to care, and fertility treatment outcomes.

Conclusion(s)

Racial and ethnic differences in access to full-spectrum reproductive care, including infertility evaluation and treatment, remain. Despite access to infertility treatment, disparate treatment outcomes persist. Intrinsic and extrinsic factors, such as the institutionalization of racism and discrimination within medicine, remain influential in the diagnosis, care, and treatment outcomes of individuals with infertility. To address these inequities, we should mitigate provider bias, fund high-quality health disparity research, improve patient reproductive health knowledge, and advocate for increased access to treatment for all.

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来源期刊
F&S reviews
F&S reviews Endocrinology, Diabetes and Metabolism, Obstetrics, Gynecology and Women's Health, Urology
CiteScore
3.70
自引率
0.00%
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审稿时长
61 days
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