An underweight and preterm newborn is connected with racial discrimination based on ethnicity, skin colour, or nationality, according to a pooled data analysis of the available evidence. The study’s findings were published in the journal ‘BMJ Global Health.’ According to the researchers, the study adds to the body of data indicating race discrimination is a risk factor for poor health outcomes.
Race has long been recognised as a social determinant of health and a risk factor for a variety of illnesses. The evidence is mounting that upstream social, environmental, economic, and political variables are primary drivers of health disparities, and that racism, rather than race, is frequently the main cause.
Maternal mortality rates for Black and Indigenous women in the United States, for example, are 2-3 times greater than those of White women. Similarly, in the United Kingdom, maternal mortality rates among Black and Asian women are 2-4 times greater than among White women.
To investigate existing patterns of racial disparities in pregnancy outcomes, the researchers searched eight electronic databases for relevant studies on self-reported race discrimination and premature birth (before 37 weeks), low birth weight, and high blood pressure associated with pregnancy that were published up to January 2022.
In total, the results of 24 studies were included in the final analysis, with the number of participants ranging from 39 to 9470 in each study. The majority (20) of the studies were conducted in the United States.
Participants in the study were from a variety of ethnic and racial origins, including Black or African American, Hispanic, non-Hispanic white, Maori, Pacific, Asian, Aboriginal, Romani, indigenous German, and Turkish.
Newborn and Descrimination
The pooled data analysis revealed that race discrimination was related with an increased risk of preterm delivery and giving birth to a small-for-gestational-age infant for all outcomes evaluated.
The total risk of preterm birth was predicted to be 40% greater. Even once low-quality studies were eliminated, the risks of preterm birth remained 31% higher. While not statistically significant, the total odds of having a baby that is tiny for gestational age were calculated to be 23% greater.
When additional studies of chosen data were performed, similar findings were observed.
The researchers admit that many of the studies included in the pooled data analysis were of low quality, that the majority were based in the United States, and that few marginalised racial or ethnic groups other than African Americans were included. As a result, they may be less appropriate to different ethnic groups and cultural circumstances.
“Our findings fit with current research on perceived racial discrimination as a significant risk factor for unfavourable pregnancy outcomes,” they say.
They elaborate: “Racism, which is pervasive in people’s daily lives, has far-reaching consequences for the experiences of racialised people. It influences other socioeconomic determinants of health, such as employment, poverty, education, and housing, as an upstream factor.
“In terms of health, racism can have an effect on the services and resources that are accessible, such as referral to specialised treatment, access to health insurance, and access to public health services.”
The researchers emphasise different measures of counteracting the impact of racism on health outcomes, including the need to increase clinician training.
They propose “universally deleting well-documented incidences of racial prejudice that continue to promote health inequalities.”
“This includes inadequate teaching on dermatology and differential disease presentations in non-White people, inaccuracies in pulse oximetry technology, unsubstantiated race-based adjustments to measuring renal function, and inadequate teaching on individual biases and the social drivers of health inequities.”