Interventions to mitigate pregnancy-related mortality and morbidity in Black birthing people: a systematic review.

Autor: Toval CA; School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC (Toval)., Darivemula SM; Division of General Obstetrics, Gynecology, and Midwifery, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC (Darivemula)., Wilson TD; University of North Carolina at Chapel Hill, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Chapel Hill, NC (Wilson, Young)., Conklin JL; University of North Carolina at Chapel Hill Health Sciences Library, Chapel Hill, NC (Conklin)., Young OM; University of North Carolina at Chapel Hill, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Chapel Hill, NC (Wilson, Young). Electronic address: omar_young@med.unc.edu.
Jazyk: angličtina
Zdroj: American journal of obstetrics & gynecology MFM [Am J Obstet Gynecol MFM] 2024 Oct; Vol. 6 (10), pp. 101464. Date of Electronic Publication: 2024 Aug 13.
DOI: 10.1016/j.ajogmf.2024.101464
Abstrakt: Objective: To conduct a systematic review of interventions to improve perinatal outcomes to mitigate pregnancy-related mortality and morbidity in Black birthing people.
Data Sources: We searched 5 databases from 2000 through the final search date of April 5, 2023: Cumulative Index of Nursing and Allied Health Literature Plus with Full Text (EBSCOhost), Embase (Elsevier), PubMed, and Scopus (Elsevier) and ClinicalTrials.gov.
Study Eligibility Criteria: Only quantitative studies were eligible including observational and randomized controlled trials. All participants in selected studies must identify as Black or study results must be stratified by race that includes Black birthing people. The study must (1) measure a perinatal outcome of interest (2) occur in the United States and (3) be written in the English language. Studies were excluded if they were published prior to 2000, not published in the English language, or did not meet the criteria above.
Study Appraisal and Synthesis Methods: A data extraction template identified intervention type and perinatal outcome. Perinatal outcomes included but were not limited to: cardiovascular disorders, mortality, or preterm delivery. Interventions included: community programs, educational enhancement, individual counseling, medical intervention, or policy. Risk of bias was assessed using the Mixed Method Appraisal Tool. Three investigators assessed studies individually and group consensus was used for a final decision.
Results: From 4,302 unique studies, 41 studies met inclusion criteria. Community programs such as the Supplemental Program for Women, Infants, and Children (WIC) and Healthy Start (n=17, 41.5%) were the most common interventions studied. Individual counseling closely followed (n=15, 36.6%). Medical interventions were not among the more commonly used intervention types (n=9, 21.9%). Most articles focused on preterm delivery (n=28, 68.3%). Few articles studied cardiovascular disorders (n=4, 9.8%) or hemorrhage (n=3, 7.3%). No articles studied pregnancy-related morbidity.
Conclusions: Despite current conversations on Black maternal mortality, there is currently limited literature examining interventions addressing perinatal morbidity and mortality in Black birthing people in the United States. These interventions do not address how to mitigate perinatal outcomes of interest. Patient-centered outcomes research is warranted to better understand as well as to resolve inequities related to Black maternal health. El resumen está disponible en Español al final del artículo.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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