Nguyen et al.,2626 Nguyen KH, Subramanian SV, Sorensen G, Tsang K, Wright RJ. Influence of experiences of racial discrimination and ethnic identity on prenatal smoking among urban black and Hispanic women. J Epidemiol Community Health. 2012;66(4):315-21. PMID: 20974840; https://doi.org/10.1136/jech.2009.107516. https://doi.org/10.1136/jech.2009.107516...
2012/CS |
Racial discrimination in relation to PN smoking |
EODQ |
Baseline interview at mean of 26.9 weeks of gestation |
n = 677 -n = 265 black -n = 412 Hispanic |
EODQ (whole sample) - moderate: (adjusted OR 1.00) - none: (adjusted OR 1.67; CI 0.86-3.21) - high: (adjusted OR 2.64; CI 1.25-5.60) EODQ (stratified) Hispanic women - moderate: (adjusted OR 1.00) - none: (adjusted OR 2.45; CI 0.90-6.70) - high: (adjusted OR 2.08; CI 0.60-7.14) Black women - moderate: (adjusted OR 1.00) - none: (adjusted OR 1.05; CI 0.42-2.62) – high: (adjusted OR 3.36; CI 1.23-9.19) |
Slaughter-Acey et al.,2828 Slaughter-Acey JC, Caldwell CH, Misra DP. The influence of personal and group racism on entry into prenatal care among African American women. Womens Health Issues. 2013;23(6):e381-7. PMID: 24041828; https://doi.org/10.1016/j.whi.2013.08.001. https://doi.org/10.1016/j.whi.2013.08.00...
2013/CH |
Racism in relation to PN care |
DRI: RaLES |
At 22 to 28 weeks of gestation and then during postpartum hospitalization |
n = 762 African-American |
Prenatal care entry 4-6 months
- –
Overall DRI: (crude OR 1.08; CI 0.95-1.23) and (adjusted OR 1.00; CI 0.87-1.14)
- –
Denial of personal racism: (crude OR 1.05; CI 0.88-1.26) and (adjusted OR 0.95; CI 0.78-1.14)
- –
Denial of group racism: (crude OR 1.24; CI 0.96-1.61) and (adjusted OR 1.12; CI 0.85-1.47) Prenatal care entry ≥ 7 months or no care
- –
Overall DRI: (crude OR 1.20; CI 1.02-1.42) and (adjusted OR 1.19; CI 1.00-1.41)
- –
Denial of personal racism: (crude OR 1.12; CI 0.89-1.42) and (adjusted OR 1.08; CI 0.84-1.38)
- –
Denial of group racism: (crude OR 1.64; CI 1.20-2.25) and (adjusted OR 1.64; CI 1.18-2.28)
|
Bécares et al.,2929 Bécares L, Atatoa-Carr P. The association between maternal and partner experienced racial discrimination and prenatal perceived stress, prenatal and postnatal depression: findings from the growing up in New Zealand cohort study. Int J Equity Health. 2016;15(1):155. PMID: 27658457; https://doi.org/10.1186/s12939-016-0443-4. https://doi.org/10.1186/s12939-016-0443-...
2016/CS |
Racial discrimination in relation to PN perceived stress |
EODQ |
Last trimester of pregnancy |
n = 3,355 women |
Personal attack: Physical attack ever: (coeff. 1.27; CI −0.18-2.72); physical attack past: (coeff. 1.14; CI −1.20-3.49) Verbal attack ever: (coeff. 1.68; CI 1.06-2.29); verbal attack past: (coeff. 1.62; CI 0.74-2.49) Any personal attack ever: (coeff. 1.68; CI 1.08-2.28); any personal attack past: (coeff. 1.50; CI 0.65-2.35) Unfair treatment: Healthcare professional ever: (coeff. 1.42; CI 0.44-2.39); healthcare professional past: (coeff. 1.79; CI 0.51-3.07) Work ever: (coeff. 2.08; CI 1.20-2.97); work past: (coeff. 1.23; CI −0.23-2.69) Housing ever: (coeff. 1.51; CI 0.58-2.44); housing past: (coeff. 2.27, CI 0.81-3.74) Criminal justice system ever: (coeff. 1.22; CI 0.05-2.38); criminal justice system past: (coeff. 1.25; CI −0.56-3.07) Banking system ever: (coeff. 2.55; CI 1.05-4.04); banking system past: (coeff. 1.21; CI −1.06-3.48) Educational system ever: (coeff. 0.98; CI 0.15-1.82); educational system past: (coeff. 1.75; CI −0.50-3.99) One experience ever: (coeff. 1.08, CI 0.43-1.73); one experience past: (coeff. 1.64; CI 0.84-2.44) Two or more experiences ever: (coeff. 2.65; CI 1.95-3.35); two or more experiences past: (coeff. 2.02; CI 0.91-3.12) |
Slaughter-Acey et al.,2727 Slaughter-Acey JC, Sneed D, Parker L, et al. Skin Tone Matters: Racial Microaggressions and Delayed Prenatal Care. Am J Prev Med. 2019;57(3):321-9. PMID: 31353164; https://doi.org/10.1016/j.amepre.2019.04.014. https://doi.org/10.1016/j.amepre.2019.04...
2019/CH |
Racial macro-aggressions in relation to delayed PN care |
20-item DLE-B |
Interviewed 24-48 hours after delivery |
-n = 909 first PN care -n = 300 no or late PN care |
-
–
African-American women with DLE-B score > 71 for no or late PNC: (unadjusted OR = 1.24; 95% CI = 0.95-1.61) and (adjusted OR = 1.31; 95% CI = 1.00-1.72)
-
–
Stratified according to maternal skin tone with DLE-B score > 71 for no or late PNC: light brown African-American women (adjusted OR = 1.67; 95% CI = 1.02- 2.71) and dark brown African-American women (adjusted OR = 2.29; 95% CI = 1.18-4.43)
|
Stancil et al.,3030 Stancil TR, Hertz-Picciotto I, Schramm M, Watt-Morse M. Stress and pregnancy among African-American women. Paediatr Perinat Epidemiol. 2000;14(2):127-35. PMID: 10791655; https://doi.org/10.1046/j.1365-3016.2000.00257.x. https://doi.org/10.1046/j.1365-3016.2000...
2000/CS |
Racial discrimination in relation to pregnancy outcomes |
EODQ |
In first half and second half of pregnancy |
n = 94 African-American |
Racial discrimination - ever: 54.3% (51); applying for housing: 23.4% (22); applying for a job: 28.7% (27); at school: 26.6% (25); getting medical care: 7.4% (7); dealing with police or in court: 11.7% (11); at work: 28.7% (27); other: 7.4% (7) |
Christian et al.,3535 Christian LM, Iams JD, Porter K, Glaser R. Epstein-Barr virus reactivation during pregnancy and postpartum: effects of race and racial discrimination. Brain Behav Immun. 2012;26(8):1280-7. PMID: 22940537; https://doi.org/10.1016/j.bbi.2012.08.006. https://doi.org/10.1016/j.bbi.2012.08.00...
2012/CS |
Racial discrimination in relation to Epstein-Barr virus (EBV) reactivation in pregnancy and postpartum |
EODQ |
1st, 2nd and 3rd trimesters and at 4-9 weeks postpartum |
n = 56 -n = 38 African-American -n = 18 white |
-
–
High versus low discrimination: higher EBV virus capsid antigen immunoglobulin G (VCA IgG) antibody titers during the first (P = 0.03) and second trimesters of pregnancy (P = 0.04); 3rd trimester (P = 0.12) and at postpartum (P = 0.06)
-
–
White vs African American women
Higher EBV VCA IgG antibody titers at all three trimesters and at postpartum [high discrimination: P values < 0.001; low discrimination: P = 0.01 (1st), 0.001 (2nd), 0.002 (3rd) and 0.001 (postpartum)
|
Hilmert et al.,3636 Hilmert CJ, Dominguez TP, Schetter CD, et al. Lifetime racism and blood pressure changes during pregnancy: implications for fetal growth. Health Psychol. 2014;33(1):43-51. PMID: 23379383; https://doi.org/10.1037/a0031160. https://doi.org/10.1037/a0031160...
2014/CS |
Racism in relation to blood pressure changes during pregnancy |
EODQ |
22 to 24 weeks of gestation |
-n = 39 African-American women |
Diastolic blood pressure (DBP) change analyses: Racism in relation to changes in DBP interactions was significant in the analyses involving childhood: indirect racism (β = - 0.36; ΔR22 Gadson A, Akpovi E, Mehta PK. Exploring the social determinants of racial/ethnic disparities in prenatal care utilization and maternal outcome. Semin Perinatol. 2017;41(5):308-17. PMID: 28625554; https://doi.org/10.1053/j.semperi.2017.04.008. https://doi.org/10.1053/j.semperi.2017.0...
= 0.12; P < 0.01); and childhood personal racism (β= −0.30; ΔR22 Gadson A, Akpovi E, Mehta PK. Exploring the social determinants of racial/ethnic disparities in prenatal care utilization and maternal outcome. Semin Perinatol. 2017;41(5):308-17. PMID: 28625554; https://doi.org/10.1053/j.semperi.2017.04.008. https://doi.org/10.1053/j.semperi.2017.0...
= 0.07; P < 0.05), both showing the same pattern of associations depicted. Systolic blood pressure (SBP) change analyses. Parallel analyses on changes in SBP did not reveal any statistically significant results (all P values > 0.05). |
Peters et al.,3737 Peters RM, Benkert R, Templin TN, Cassidy-Bushrow AE. Measuring African American women's trust in provider during pregnancy. Res Nurs Health. 2014;37(2):144-54. PMID: 24395526; https://doi.org/10.1002/nur.21581. https://doi.org/10.1002/nur.21581...
2014/CS |
African-American women's trust in provider during pregnancy |
Trust in Physician Scale RaLES-Brief |
Once a month during weeks 4-28; every 2 weeks during weeks 28-36 and every week from week 36 until birth |
n = 189 African American women |
Trust was inversely associated with previous experience of racism, specifically in healthcare (r = −0.16; P = 0.03), as women who reported experiencing racism in healthcare had significantly lower trust scores than women who did not report such an experience (t (187) = 2.17; P = 0.03) |
Yang et al.,3838 Yang TC, Shoff C, Noah AJ, Black N, Sparks CS. Racial segregation and maternal smoking during pregnancy: a multilevel analysis using the racial segregation interaction index. Soc Sci Med. 2014;107:26-36. PMID: 24602968; https://doi.org/10.1016/j.socscimed.2014.01.030. https://doi.org/10.1016/j.socscimed.2014...
2014/CS |
Racial segregation in relation to maternal smoking during pregnancy |
Racial Segregation Index |
Pregnancy |
County-level n = 2556 (NHW) (59%) (NHB) (16%) (NHA) (4%) (H) (21%). |
Racial segregation index: NHB: living in a county where blacks are more segregated from whites was associated with higher probability of maternal smoking during pregnancy NHA: Asian women seemed to benefit more from living in a county where Asians were segregated from whites than in a county where these two racial groups were integrated H: Living in a Hispanic-white segregated community could be beneficial for Hispanic mothers |
Attanasio et al.,3939 Attanasio L, Kozhimannil KB. Patient-reported Communication Quality and Perceived Discrimination in Maternity Care. Med Care. 2015;53(10):863-71. PMID: 26340663; https://doi.org/10.1097/MLR.0000000000000411. https://doi.org/10.1097/MLR.000000000000...
2015/CS |
Perceived discrimination in maternity care |
|
Before, during and after recent birth |
n = 2,231 -n = 1,308 NHW -n = 368 NHB -n = 555 H |
Race: Maternal health:
- –
Pregnancy hypertension: (adjusted OR 2.41; CI 1.38-4.22)
- –
Diabetes (adjusted OR 3.25; CI 2.09-5.04)
- –
Obese pre-pregnancy (adjusted OR 0.63; CI 0.35-1.13)
|
Borders et al.,4040 Borders AE, Wolfe K, Qadir S, et al. Racial/ethnic differences in self-reported and biologic measures of chronic stress in pregnancy. J Perinatol. 2015;35(8):580-4. PMID: 25789817; https://doi.org/10.1038/jp.2015.18. https://doi.org/10.1038/jp.2015.18...
2015/CH |
Hormonal and inflammatory measurements of chronic stress during pregnancy according to racial discrimination scale |
EODQ |
14 and 22 weeks of gestation |
Total: n = 112
|
Krieger Discrimination Scale P < 0.001 – blacks: 11.3 ± 1.7 – whites: 13.3 ± 0.9 Association of mean stress biomarkers with race NHB women had significantly higher mean C-reactive protein levels in the second trimester (12.7 ± 11.9 versus 7.4 ± 8.3; P < 0.01) and third trimester (12.2 ± 14.9 versus 6.9 ± 7.4; P = 0.04) relative to NHW women. NHB women also had significantly higher adrenocorticotropic hormone levels in the second trimester (21.6 ± 11.9 versus 16.5 ± 8.5; P = 0.01) and third trimester (6.4 ± 15.1 versus 3.9 ± 4.0; P = 0.03) relative to NHW women. No differences in Epstein-Barr virus or corticotropin-releasing hormone levels were detected between the two racial/ethnic groups |
Grobman et al.,3131 Grobman WA, Parker C, Wadhwa PD, et al. Racial/Ethnic Disparities in Measures of Self-reported Psychosocial States and Traits during Pregnancy. Am J Perinatol. 2016;33(14):1426-32. PMID: 27500932; https://doi.org/10.1055/s-0036-1586510. https://doi.org/10.1055/s-0036-1586510...
2016/CH |
Psychosocial states and traits during pregnancy |
EODQ |
21 weeks of gestation. |
n = 7,690 |
|
Grobman et al.,3232 Grobman WA, Parker CB, Willinger M, et al. Racial Disparities in Adverse Pregnancy Outcomes and Psychosocial Stress. Obstet Gynecol. 2018;131(2):328-35. PMID: 29324613; https://doi.org/10.1097/AOG.0000000000002441. https://doi.org/10.1097/AOG.000000000000...
2018/CH |
Associations of preterm birth, hypertensive disease of pregnancy and SGA birth with self-reported measurements of psychosocial stress |
EODQ |
16 and 21 weeks of gestation |
n = 8,962 |
Hypertensive disease of pregnancy
- –
NHB (OR 0.98; CI 0.81-1.20)
- –
H (OR 0.71; CI 0.58-0.86)
- –
Asian (OR 0.82; CI 0.56-1.20)
- –
Other (OR 0.85; CI 0.63-1.14)
- –
Krieger > 3 (OR 0.81; CI 0.62-1.06)
|
Mendez et al.,3333 Mendez DD, Sanders SA, Lai YH, et al. Ecological momentary assessment of stress, racism and other forms of discrimination during pregnancy using smartphone technology. Paediatr Perinat Epidemiol. 2020;34(5):522-31. PMID: 31930744; https://doi.org/10.1111/ppe.12619. https://doi.org/10.1111/ppe.12619...
2020/CH |
Racism in relation to pregnancy and postpartum |
|
18-32 weeks of gestation and at delivery |
n = 230 -n = 146 white -n = 57 black |
Only descriptive: black participants indicated more racism than white participants, and white participants indicated more sexism than black participants |
Chambers et al.,3434 Chambers BD, Arabia SE, Arega HA, et al. Exposures to structural racism and racial discrimination among pregnant and early post-partum Black women living in Oakland, California. Stress Health. 2020;36(2):213-9. PMID: 31919987; https://doi.org/10.1002/smi.2922. https://doi.org/10.1002/smi.2922...
2020/CS |
Racial discrimination among pregnant and postpartum black women |
ICE (concentrations at the extremes) race + income measurement (formula) |
Currently pregnant or early postpartum (6 weeks) with a singleton birth |
n = 42 -n = 20 least deprived -n = 22 most deprived |
Racial Discrimination
- –
93% of the women: at least one situational domain
- –
59.5% of the women: in three or more situational domains
- –
The three most common situational domains were at school (59.5%), on the street or in a public setting (59.5%) and getting service in a store or restaurant (54.8%)
|
Francis et al.,4141 Francis B, Klebanoff M, Oza-Frank R. Racial discrimination and perinatal sleep quality. Sleep Health. 2017;3(4):300-5. PMID: 28709519; https://doi.org/10.1016/j.sleh.2017.05.012. https://doi.org/10.1016/j.sleh.2017.05.0...
2017/CS |
Racial discrimination in relation to perinatal sleep quality |
EODQ |
Each trimester and postpartum |
n = 640
- –
PN n = 247
- –
Postnatal n = 393
|
Cross-sectional unadjusted analysis associations between discrimination and overall sleep quality:
- –
Overall (overall sleep quality 0.058) - prenatal (overall sleep quality 0.042) - postpartum (overall sleep quality 0.076)
- –
Black (overall sleep quality 0.048)
- –
White (overall sleep quality 0.072)
|
Attanasio et al.,1818 Attanasio L, Kozhimannil KB. Health Care Engagement and Follow-up After Perceived Discrimination in Maternity Care. Med Care. 2017;55(9):830-3. PMID: 28692572; https://doi.org/10.1097/MLR.0000000000000773. https://doi.org/10.1097/MLR.000000000000...
2017/CS |
Perceived discrimination during hospitalization for childbirth |
Survey |
8 weeks after birth |
n = 2,400 |
Perceived discrimination during hospitalization for childbirth and non-attendance of postpartum visit (multivariate models) – Treated poorly due to race: (unadjusted OR 2.11; CI 1.25-3.57) and (adjusted OR 2.11; CI 1.15-3.87) |