Defining an Infant's Race and Ethnicity: A Systematic Review

Abstract

Context: Infant race and ethnicity are used ubiquitously in research and reporting, though inconsistent approaches to data collection and definitions yield variable results. The consistency of these data has an impact on reported findings and outcomes.

Objective: To systematically review and examine concordance among differing race and ethnicity data collection techniques presented in perinatal health care literature.

Data sources: PubMed, CINAHL, and Ovid were searched on June 17, 2021.

Study selection: English language articles published between 1980 and 2021 were included if they reported on the United States' infant population and compared 2 or more methods of capturing race and/or ethnicity.

Data extraction: Two authors independently evaluated articles for inclusion and quality, with disagreements resolved by a third reviewer.

Results: Our initial search identified 4329 unique citations. Forty articles passed title/abstract review and were reviewed in full text. Nineteen were considered relevant and assessed for quality and bias, from which 12 studies were ultimately included. Discordance in infant race and ethnicity data were common among multiple data collection methods, including those frequently used in perinatal health outcomes research. Infants of color and those born to racially and/or ethnically discordant parents were the most likely to be misclassified across data sources.

Limitations: Studies were heterogeneous in methodology and populations of study and data could not be compiled for analysis.

Conclusions: Racial and ethnic misclassification of infants leads to inaccurate measurement and reporting of infant morbidity and mortality, often underestimating burden in minoritized populations while overestimating it in the non-Hispanic/Latinx white population.

FIGURE 1

PRISMA flow diagram.

FIGURE 2

Timeline of relevant change to the US standard birth certificate.