Racial disparities in early pregnancy: a narrative review.

Abstract

This review introduces the recognized body of evidence on social determinants of health, which continue to show that a person's health is determined by their broader environmental and social context and that societal inequities harm health and healthcare outcomes. An area of inequity is race, which, although a social construct, has a significant impact on a person's morbidity and mortality as well as their access and experience of healthcare. Racial disparities in maternal and perinatal outcomes are widely recognized. Therefore, this review focuses on the less commonly addressed early pregnancy setting. Health inequities are present in the early pregnancy setting, as racial disparities exist in early pregnancy presentations and outcomes. Black women have a higher incidence of miscarriage, ectopic pregnancy and poorer survival rates from gestational trophoblastic neoplasms. Asian women have a statistically significantly higher incidence of gestational trophoblastic disease. The findings support the need for more consistent and detailed research on the impact of race on early pregnancy outcomes and increasing ethnic diversity among study populations for trials to ensure meaningful and applicable data. Raising awareness of this racial health inequity in early pregnancy is the first step clinicians can take to tackle this issue.