Racial/Ethnic Representation in United States and Australian Obstetric Research

Abstract

Objective

To describe racial/ethnic representation in United States (US) and Australian obstetric research, represented by the Maternal-Fetal Medicine Units Network (MFMU) and Australian Research Centre for Health of Women and Babies (ARCH) trials.

Methods

MFMU studies were identified through PubMed and ARCH studies through their online publication listing from 2011 to 2016. Observational and randomized cohorts and primary and secondary data analyses were included. Studies with race-based enrollment were excluded. Racial/ethnic representation was expressed as the mean racial/ethnic percentages of the studies (i.e.,: studies weighted equally regardless of sample size). Racial/ethnic percentages in MFMU studies were compared to US registered births and ARCH compared to Australian census ancestry data.

Results

38 MFMU studies included 580,282 women. Racial/ethnic representation (% [SD]) included White 41.7 [12.3], Hispanic 28.1 [15.4], Black 26.2 [12.3], Asian 3.6 [2.3], and American Indian/Alaskan Native (AI/AN) 0.2 [0.02]. No studies reported Native Hawaiian/other Pacific Islanders (NHOPI) separately. Comparatively, registered US births (%) were White 75.7, Hispanic 28.1, Black 16.1, Asian/Pacific Islander 7.1, and AI/AN 1.1, which differed from the MFMU (P = 0.02). 20 ARCH studies included 51,873 women. The most reported groups were White 76.5 [17.4], Asian 15.2 [14.8], and Aboriginal/Torres Strait Islander 13.9 [30.5], compared to census numbers of White 88.7, Asian 9.4, and Aboriginal/Torres Strait Islander 2.8 (P < 0.01). Two ARCH studies reported African ethnicity.

Conclusion

There is racial diversity in studies by MFMU and ARCH, with opportunities to increase enrollment and enhanced reporting of Asian, AI/AN, and NHOPI races in MFMU studies and Black race in ARCH studies.

This is a preview of subscription content, log in to check access.

Reference

  1. American College of Obstetricians and Gynecologists. (2015). Committee opinion No. 649: Racial and ethnic disparities in obstetrics and gynecology. Obstetrics and Gynecology, 126(6), e130–e134.

    Article  Google Scholar 

  2. Australia Bureau of Statistics. (2017). Australian Bureau of Statistics, Australian Government. http://www.abs.gov.au/websitedbs/D3310114.nsf/home/Home. Accessed 24 Nov 2017.

  3. Berggren, E. K., Mele, L., Landon, M. B., Spong, C. Y., Ramin, S. M., Casey, B., et al. (2012). Perinatal outcomes in Hispanic and non-Hispanic white women with mild gestational diabetes. Obstetrics & Gynecology, 120(5), 1099–1104.

    Article  Google Scholar 

  4. Chalouhi, S. E., Tarutis, J., Barros, G., Starke, R. M., & Mozurkewich, E. L. (2015). Risk of postpartum hemorrhage among Native American women. International Journal of Gynecology & Obstetrics, 131(3), 269–272.

    Article  Google Scholar 

  5. Chen, M. S., Jr., Lara, P. N., Dang, J. H., Paterniti, D. A., & Kelly, K. (2014). Twenty years post-NIH Revitalization Act: enhancing minority participation in clinical trials (EMPaCT): Laying the groundwork for improving minority clinical trial accrual: renewing the case for enhancing minority participation in cancer clinical trials. Cancer, 120(Suppl 7), 1091–1096.

    Article  Google Scholar 

  6. Colby, S. L., & Ortman, J. M. (2014). Projections of the size and composition of the US population: 2014 to 2060, Current Population Reports, P25–1143. Washington, DC: U.S. Census Bureau.

    Google Scholar 

  7. Gordon, N. P., Lin, T. Y., Rau, J., & Lo, J. C. (2019). Aggregation of Asian-American subgroups masks meaningful differences in health and health risks among Asian ethnicities: an electronic health record based cohort study. BMC Public Health, 19(1), 1551.

    Article  Google Scholar 

  8. Humes, K., & Hogan, H. (2009). Measurement of race and ethnicity in a changing, multicultural America. Race and Social Problems, 1, 111.

    Article  Google Scholar 

  9. Manuck, T. A., Lai, Y., Meis, P. J., Sibai, B., Spong, C. Y., Rouse, D. J., et al. (2011). Admixture mapping to identify spontaneous preterm birth susceptibility loci in African Americans. Obstetrics & Gynecology, 117(5), 1078–1084.

    Article  Google Scholar 

  10. Martin, J. A., Hamilton, B. E., Osterman, M. J., Driscoll, A. K., & Matthews, T. J. (2017). Births: Final data for 2015. National Vital Statistics Reports, 66(1), 1–70.

    PubMed  Google Scholar 

  11. Mathews, K., Phelan, J., Jones, N. A., Konya, S., Marks, R., Pratt, B. M., et al. (2017). 2015 National content test race and ethnicity analysis report: A new design for the 21st century. Washington, DC: US Census Bureau.

    Google Scholar 

  12. Mays, V. M., Ponce, N. A., Washington, D. L., & Cochran, S. D. (2003). Classication of race and ethnicity: Implications for public health. Annual Review of Public Health, 24, 83–110.

    Article  Google Scholar 

  13. Mishkin, G., Minasian, L. M., Kohn, E. C., Noone, A. M., & Temkin, S. M. (2016). The generalizability of NCI-sponsored clinical trials accrual among women with gynecologic malignancies. Gynecologic Oncology, 143(3), 611–616.

    Article  Google Scholar 

  14. Morisako, A. K., Tauali’i, M., Ambrose, A. J. H., & Withy, K. (2017). Beyond the ability to pay: The health status of Native Hawaiians and other Pacific Islanders in relationship to health insurance. Hawai’i Journal of Medicine & Public Health, 76(31), 36–41.

    Google Scholar 

  15. National Institutes of Health. (2001). NIH Policy and Guidelines on The Inclusion of Women and Minorities as Subjects in Clinical Research – Amended. https://grants.nih.gov/grants/funding/women_min/guidelines_amended_10_2001.htm. Accessed Oct 2020

  16. Raglan, G. B., Lannon, S. M., Jones, K. M., & Schulkin, J. (2016). Racial and ethnic disparities in preterm birth among American Indian and Alaska Native women. Maternal and Child Health Journal, 20(1), 16–24.

    Article  Google Scholar 

  17. Salazar, A., Tolivaisa, S., Allard, D., Bishop, T. S., Bousleiman, S., Clark, K., et al. (2016). What we have learned about best practices for recruitment and retention in multicenter pregnancy studies. Seminars in Perinatology, 40(5), 321–327.

    Article  Google Scholar 

  18. Schempf, A. H., Mendola, P., Hamilton, B. E., Hayes, D. K., & Makuc, D. M. (2010). Perinatal outcomes for Asian, Native Hawaiian, and other Pacific Islander mothers of single and multiple race/ethnicity: California and Hawaii, 2003–2005. American Journal of Public Health, 100(5), 877–887.

    Article  Google Scholar 

  19. The University of Adelaide. (2017). Australian Research Centre for Health of Women and Babies (ARCH). Clinical Trials and Studies Research Networks. http://www.adelaide.edu.au/arch/research/clinical_trials/. Accessed 24 Nov 2017.

  20. United States Census Bureau. (2013). Race. http://www.census.gov/topics/population/race/about.html. Accessed 26 Jan 2017.

Download references

Funding

None.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Kelly Yamasato.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendix

Appendix

See Tables 3, 4

Table 3 Included eunice kennedy shriver national institute of child health and human development maternal-fetal medicine (MFMU) units network studies
Table 4 Included australian research centre for health of women and babies studies

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Yamasato, K., Chern, I. & Lee, MJ. Racial/Ethnic Representation in United States and Australian Obstetric Research. Matern Child Health J (2020). https://doi.org/10.1007/s10995-020-03099-8

Download citation

Keywords

  • Pregnancy
  • Obstetric
  • Race
  • Ethnicity