This systematic review examined 16 US studies of racial differences in drug toxicology testing during pregnancy and infancy; six studies contributed to a meta-analysis. Black women and infants were substantially more likely to undergo testing than White counterparts, with a pooled rate ratio of 2.58. Evidence about subsequent child protective services involvement was less consistent. The authors identify unequal testing as an important health-equity concern and recommend transparent, clinically justified testing practices alongside supportive rather than punitive care.
