Urogynecology (Philadelphia, Pa.) · 2026
Association of Race and Ethnicity as Risk Factors for OASIs: A Systematic Review.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Mou Tsung, Ramos Sebastian, Hall Evelyn, Camarlinghi Madison, Rabinowitz Judy, Brown Oluwateniola
Аннотация
IMPORTANCE: Understanding how race and ethnicity are contextualized as risk factors for obstetric anal sphincter injuries (OASIs) can improve efforts to address maternal health disparities.
OBJECTIVES: Our primary aim was to conduct a systematic review and meta-analysis to examine the association between race/ethnicity and OASI incidence. The secondary aim was to critique how included studies contextualized race/ethnicity as risk factors for OASIs.
STUDY DESIGN: This systematic review analyzed observational studies reporting OASI incidence by race and ethnicity. The primary outcome was the overall incidence of OASIs, with odds ratios (OR) calculated using a random effects model. We quantified the racial representation in the included studies using a representation quotient (RQ) analysis and applied the Obstetrics & Gynecology's equity rubric for structured critique.
RESULTS: Out of 3,896 studies, 12 were included. The overall OASI incidence was 4.44% (95% CI, 2.69-6.60%), with Asian American and Pacific Islander (AAPI) individuals having the highest incidence at 5.69% (95% CI, 4.04-7.59%). AAPI individuals had higher odds of OASIs compared with White individuals (OR, 1.61; 95% CI, 1.12-2.31). Two studies provided disaggregated AAPI data by ethnicity. Native American (RQ 0), Black (RQ 0.15), and Hispanic (RQ 0.20) individuals were underrepresented. Among studies that identified racial disparities, 33% attributed findings to systemic factors, 45% did not address disparities, and 22% suggested biological differences without substantiated evidence.
CONCLUSIONS: AAPI individuals had 61% higher odds of experiencing OASIs than White individuals. However, most studies aggregated AAPI data, failed to represent the U.S. population, and overlooked system-level factors contributing to the racial disparity in OASI incidence.
OBJECTIVES: Our primary aim was to conduct a systematic review and meta-analysis to examine the association between race/ethnicity and OASI incidence. The secondary aim was to critique how included studies contextualized race/ethnicity as risk factors for OASIs.
STUDY DESIGN: This systematic review analyzed observational studies reporting OASI incidence by race and ethnicity. The primary outcome was the overall incidence of OASIs, with odds ratios (OR) calculated using a random effects model. We quantified the racial representation in the included studies using a representation quotient (RQ) analysis and applied the Obstetrics & Gynecology's equity rubric for structured critique.
RESULTS: Out of 3,896 studies, 12 were included. The overall OASI incidence was 4.44% (95% CI, 2.69-6.60%), with Asian American and Pacific Islander (AAPI) individuals having the highest incidence at 5.69% (95% CI, 4.04-7.59%). AAPI individuals had higher odds of OASIs compared with White individuals (OR, 1.61; 95% CI, 1.12-2.31). Two studies provided disaggregated AAPI data by ethnicity. Native American (RQ 0), Black (RQ 0.15), and Hispanic (RQ 0.20) individuals were underrepresented. Among studies that identified racial disparities, 33% attributed findings to systemic factors, 45% did not address disparities, and 22% suggested biological differences without substantiated evidence.
CONCLUSIONS: AAPI individuals had 61% higher odds of experiencing OASIs than White individuals. However, most studies aggregated AAPI data, failed to represent the U.S. population, and overlooked system-level factors contributing to the racial disparity in OASI incidence.