Racial Differences in Birth Outcomes: The Role of General, Pregnancy, and Racism Stress

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Abstract

Objective

This study examined the role of psychosocial stress in racialdifferences in birth outcomes.

Design

Maternal health, sociodemographic factors, and 3 forms of stress(general stress, pregnancy stress, and perceived racism) were assessedprospectively in a sample of 51 African American and 73 non-Hispanic Whitepregnant women.

Main Outcome Measures

The outcomes of interest were birth weight and gestational age atdelivery. Only predictive models of birth weight were tested as the groups didnot differ significantly in gestational age.

Results

Perceived racism and indicators of general stress were correlated withbirth weight and tested in regression analyses. In the sample as a whole, lifetime and childhood indicators of perceived racism predicted birth weight andattenuated racial differences, independent of medical and sociodemographiccontrol variables. Models within each race group showed that perceived racismwas a significant predictor of birth weight in African Americans, but not innon-Hispanic Whites.

Conclusions

These findings provide further evidence that racism may play animportant role in birth outcome disparities, and they are among the first toindicate the significance of psychosocial factors that occur early in the lifecourse for these specific health outcomes.

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