关于如何或是否应在医学研究中使用种族和族裔的争论越来越多，包括将种族概念化为生物实体、社会结构或种族主义的代表。本叙述性综述的目的是识别和综合妇产科 (ob/gyn) 中报告的种族和民族不平等现象，并为妇产科中的种族和民族不平等研究提出明智的建议。对八种最具影响力的妇产科期刊进行了可重复的检索。 2010 年 1 月 1 日至 2023 年 6 月 30 日期间发表的包含与种族和民族差异、偏见、偏见、不平等和不公平相关的关键词的文章均被纳入 (n=318)。数据被提取并总结为四个主题：1）获得护理，2）遵守国家指南，3）临床结果，4）临床试验多样性。与每个主题相关的研究按主题组织在 i）产科、ii）生殖医学、iii）妇科癌症和 iv）其他标题下。此外，还开发了交互式表格。其中包括有关研究时间线、人群、地​​点和每篇文章结果的数据。这些表格使读者能够按期刊、出版年份、种族和民族以及主题进行筛选。许多研究发现，与白人患者相比，少数族裔和族裔患者的生殖结果不佳，尽管根据不同的护理机会、社会经济或生活方式因素以及临床特征进行了调整，但这种情况仍然存在。其中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、西班牙裔/拉丁裔和亚洲患者的生育治疗成功率降低；非白人患者的生存率较低，接受妇科癌症指南一致护理的可能性也较低。我们的结论是，妇产科中的许多种族和民族不平等不能完全归因于患者特征或获得护理的机会。专注于解释这些基于生物学差异的差异的研究错误地强化了种族作为生物学特征的概念。需要进行更多研究来解构种族并评估减少这些差异的干预措施的有效性。版权所有 © 2024。由 Elsevier Inc. 出版。

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 eight 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 four 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, that 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.Copyright © 2024. Published by Elsevier Inc.