PDF(Pubmed)
Abstract：
UNASSIGNED: Ethno-racial inequalities are critical determinants of health outcomes. We quantified ethnic-racial inequalities on adverse birth outcomes and early neonatal mortality in Brazil.
UNASSIGNED: We conducted a cohort study in Brazil using administrative linked data between 2012 and 2019. Estimated the attributable fractions for the entire population (PAF) and specific groups (AF), as the proportion of each adverse outcome that would have been avoided if all women had the same baseline conditions as White women, both unadjusted and adjusted for socioeconomics and maternal risk factors. AF was also calculated by comparing women from each maternal race/skin colour group in different groups of mothers\' schooling, with White women with 8 or more years of education as the reference group and by year.
UNASSIGNED: 21,261,936 newborns were studied. If all women experienced the same rate as White women, 1.7% of preterm births, 7.2% of low birth weight (LBW), 10.8% of small for gestational age (SGA) and 11.8% of early neonatal deaths would have been prevented. Percentages preventable were higher among Indigenous (22.2% of preterm births, 17.9% of LBW, 20.5% of SGA and 19.6% of early neonatal deaths) and Black women (6% of preterm births, 21.4% of LBW, 22.8% of SGA births and 20.1% of early neonatal deaths). AF was higher in groups with fewer years of education among Indigenous, Black and Parda for all outcomes. AF increased over time, especially among Indigenous populations.
UNASSIGNED: A considerable portion of adverse birth outcomes and neonatal deaths could be avoided if ethnic-racial inequalities were non-existent in Brazil. Acting on the causes of these inequalities must be central in maternal and child health policies.
UNASSIGNED: Bill & Melinda Gates Foundation and Wellcome Trust.
UNASSIGNED: We conducted a cohort study in Brazil using administrative linked data between 2012 and 2019. Estimated the attributable fractions for the entire population (PAF) and specific groups (AF), as the proportion of each adverse outcome that would have been avoided if all women had the same baseline conditions as White women, both unadjusted and adjusted for socioeconomics and maternal risk factors. AF was also calculated by comparing women from each maternal race/skin colour group in different groups of mothers\' schooling, with White women with 8 or more years of education as the reference group and by year.
UNASSIGNED: 21,261,936 newborns were studied. If all women experienced the same rate as White women, 1.7% of preterm births, 7.2% of low birth weight (LBW), 10.8% of small for gestational age (SGA) and 11.8% of early neonatal deaths would have been prevented. Percentages preventable were higher among Indigenous (22.2% of preterm births, 17.9% of LBW, 20.5% of SGA and 19.6% of early neonatal deaths) and Black women (6% of preterm births, 21.4% of LBW, 22.8% of SGA births and 20.1% of early neonatal deaths). AF was higher in groups with fewer years of education among Indigenous, Black and Parda for all outcomes. AF increased over time, especially among Indigenous populations.
UNASSIGNED: A considerable portion of adverse birth outcomes and neonatal deaths could be avoided if ethnic-racial inequalities were non-existent in Brazil. Acting on the causes of these inequalities must be central in maternal and child health policies.
UNASSIGNED: Bill & Melinda Gates Foundation and Wellcome Trust.
摘要：
■种族不平等是健康结果的关键决定因素。我们量化了巴西出生不良结局和早期新生儿死亡率的种族不平等。
■我们在2012年至2019年期间使用行政关联数据在巴西进行了一项队列研究。估计整个群体(PAF)和特定群体(AF)的归因分数，如果所有女性的基线条件与白人女性相同，则可以避免的每种不良结局的比例，未调整和调整社会经济学和孕产妇风险因素。AF还通过比较不同母亲学校教育中每个母亲种族/肤色组的妇女来计算。以受过8年或8年以上教育的白人妇女为参照组，按年份划分。
■研究了21,261,936名新生儿。如果所有女性都经历了与白人女性相同的比率，1.7%的早产，7.2%的低出生体重(LBW),10.8％的小于胎龄（SGA）和11.8％的早期新生儿死亡本来可以预防。土著居民的可预防百分比更高(22.2%的早产，LBW的17.9%，SGA的20.5％和新生儿早期死亡的19.6％）和黑人妇女（早产的6％，LBW的21.4%，22.8％的SGA出生和20.1％的早期新生儿死亡）。土著受教育年限较少的群体AF较高，布莱克和帕达的所有结果。AF随时间增加,尤其是土著居民。
如果巴西不存在种族不平等，则可以避免相当一部分不良出生结局和新生儿死亡。针对这些不平等的原因采取行动必须是妇幼保健政策的核心。
■比尔和梅琳达·盖茨基金会和惠康信托基金。
■我们在2012年至2019年期间使用行政关联数据在巴西进行了一项队列研究。估计整个群体(PAF)和特定群体(AF)的归因分数，如果所有女性的基线条件与白人女性相同，则可以避免的每种不良结局的比例，未调整和调整社会经济学和孕产妇风险因素。AF还通过比较不同母亲学校教育中每个母亲种族/肤色组的妇女来计算。以受过8年或8年以上教育的白人妇女为参照组，按年份划分。
■研究了21,261,936名新生儿。如果所有女性都经历了与白人女性相同的比率，1.7%的早产，7.2%的低出生体重(LBW),10.8％的小于胎龄（SGA）和11.8％的早期新生儿死亡本来可以预防。土著居民的可预防百分比更高(22.2%的早产，LBW的17.9%，SGA的20.5％和新生儿早期死亡的19.6％）和黑人妇女（早产的6％，LBW的21.4%，22.8％的SGA出生和20.1％的早期新生儿死亡）。土著受教育年限较少的群体AF较高，布莱克和帕达的所有结果。AF随时间增加,尤其是土著居民。
如果巴西不存在种族不平等，则可以避免相当一部分不良出生结局和新生儿死亡。针对这些不平等的原因采取行动必须是妇幼保健政策的核心。
■比尔和梅琳达·盖茨基金会和惠康信托基金。
