Racial and ethnic disparities in obstetrics are pronounced in the United States (US). In February 2018, SMFM published a special report entitled “Reducing racial and ethnic disparities in maternal morbidity and mortality: a call to action.” As SMFM’s guidelines represent the scientific basis to inform clinical decisions, it is imperative that the research they amalgamate is representative of our racially diverse US population. Our objective is to systematically calculate how often our contemporary obstetric guidelines consider race/ethnicity and how well their subjects reflect the current US census. This is a descriptive study of independent SMFM guidelines released since the publication of the SMFM special report in February 2018. Both guidelines and their cited works were analyzed for identification of racial/ethnic demographics of their study population. Only original research investigations were included for statistical analysis with chi squared test for categorical variables. Seventeen guidelines met inclusion criteria with 766 cited works. 424 (58%) of these citations were original research. Race/ethnicity was not identified in more than half (56.8%) of the research publications. Distribution of citation types and demographics identified are detailed in Figure 1. US publications were significantly more likely to report race/ethnicity than international works (67.2% vs 7.6%, OR 25.1, CI 13.4,46.8). Although the compiled demographics of US studies were roughly similar to 2019 US census data, variance between individual studies was extreme, with only a single US study having all demographics within 25% of the US census data (Figure 2). A critical element of dismantling obstetric disparities is ensuring that our research populations reflect the diversity of our country. Although recently cited US works appear to be on track overall, many individual studies do not meet this goal. Continued effort to achieve adequate demographic inclusion in research represents an opportunity to break down inequalities in patient outcomes.View Large Image Figure ViewerDownload Hi-res image Download (PPT)
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