Abstract：
There has been increasing debate around how or if race and ethnicity should be used in medical research-including the conceptualization of race as a biological entity, a social construct, or a proxy for racism. The objectives of this narrative review are to identify and synthesize reported racial and ethnic inequalities in obstetrics and gynecology (ob/gyn) and develop informed recommendations for racial and ethnic inequity research in ob/gyn. A reproducible search of the 8 highest impact ob/gyn journals was conducted. Articles published between January 1, 2010 and June 30, 2023 containing keywords related to racial and ethnic disparities, bias, prejudice, inequalities, and inequities were included (n=318). Data were abstracted and summarized into 4 themes: 1) access to care, 2) adherence to national guidelines, 3) clinical outcomes, and 4) clinical trial diversity. Research related to each theme was organized topically under the headings i) obstetrics, ii) reproductive medicine, iii) gynecologic cancer, and iv) other. Additionally, interactive tables were developed. These include data on study timeline, population, location, and results for every article. The tables enable readers to filter by journal, publication year, race and ethnicity, and topic. Numerous studies identified adverse reproductive outcomes among racial and ethnic minorities as compared to white patients, which persist despite adjusting for differential access to care, socioeconomic or lifestyle factors, and clinical characteristics. These include higher maternal morbidity and mortality among Black and Hispanic/Latinx patients; reduced success during fertility treatments for Black, Hispanic/Latinx, and Asian patients; and lower survival rates and lower likelihood of receiving guideline concordant care for gynecological cancers for non-White patients. We conclude that many racial and ethnic inequities in ob/gyn cannot be fully attributed to patient characteristics or access to care. Research focused on explaining these disparities based on biological differences incorrectly reinforces the notion of race as a biological trait. More research that deconstructs race and assesses efficacy of interventions to reduce these disparities is needed.
摘要：
关于如何或是否应在医学研究中使用种族和种族的争论越来越多，包括将种族概念化为生物学实体，一种社会结构，或是种族主义的代理人.本叙事审查的目的是确定和综合报告的妇产科（ob/gyn）中的种族和族裔不平等现象，并为ob/gyn中的种族和族裔不平等研究提供明智的建议。对八种影响最大的妇产科杂志进行了可重复的搜索。2010年1月1日至2023年6月30日之间发表的文章，其中包含与种族和民族差异有关的关键字，偏见，偏见,不平等，并包括不公平(n=318)。数据被抽象和总结为四个主题：1)获得护理，2)遵守国家指导方针，3）临床结果，4)临床试验多样性。与每个主题相关的研究是在i)产科标题下局部组织的，ii)生殖医学，iii）妇科癌症，andiv)other.此外,开发了交互式表格。这些包括研究时间表的数据，人口,location,以及每篇文章的结果。这些表使读者可以按日志过滤，出版年份,种族和民族,和主题。许多研究发现，与白人患者相比，种族和族裔少数群体的不良生殖结局。尽管调整了不同的护理机会，但这种情况仍然存在，社会经济或生活方式因素，和临床特征。这些包括黑人和西班牙裔/拉丁裔患者的孕产妇发病率和死亡率较高；黑人在生育治疗期间的成功率降低，西班牙裔/拉丁裔，和亚洲患者；非白人患者的生存率较低，接受妇科癌症指南一致治疗的可能性较低。我们得出的结论是，妇产科医生中的许多种族和族裔不平等不能完全归因于患者的特征或获得护理的机会。专注于基于生物学差异解释这些差异的研究错误地加强了种族作为生物学特征的概念。需要更多的研究来解构种族并评估干预措施的有效性，以减少这些差异。
