Health inequities start early in life, even before birth: why race-specific fetal and neonatal growth references disadvantage Black infants

Elsevier

Available online 27 August 2022, 151662

Seminars in PerinatologyAbstract

Clinicians and researchers use published standards to assess and classify the size and growth of the fetus and newborn infant. Fetal growth is slower on average in Black fetuses as compared with White fetuses, and existing standards differ in whether they are race-specific or not. Here, we apply a health equity lens to the topic of fetal and newborn growth assessment by critically appraising two widely available growth standards. We conclude that using race-based standards is not well-justified and could perpetuate or even worsen inequities in perinatal health outcomes. We therefore recommend that neonatal and perinatal providers remove race from the assessment of fetal and newborn size.

Section snippetsConclusion

As the U.S. and global societies reckon with longstanding racism, each field of medicine is being called to practice anti-racist care. Nephrologists are removing the race correction for GFR to improve equity for renal transplants.39 Hematologists are removing race-corections for anemia.40 Obstetricians are removing race from calculators to predict the success of vaginal birth after cesarean delivery.41 In keeping with a recent call from the American Academy of Pediatrics to eliminate race-based

Disclosures

The authors have no conflicts of interest or relevant financial disclosures.

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