Discrimination is associated with poor sleep quality in pregnant Black American women

Cohen, Madeleine F.; Corwin, Elizabeth J.; Johnson, Dayna A.; Amore, Alexis Dunn; Brown, April L.; Barbee, Nia R.; Brennan, Patricia A.; Dunlop, Anne L.

doi:10.1016/j.sleep.2022.07.015

Cited by 12 publications

(7 citation statements)

References 75 publications

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“…Similarly, adolescents who have experienced intimate partner violence (IPV) report higher levels of prenatal depressive symptoms than adolescents without a history of IPV [15,21 ▪ ]. In addition to exposure to childhood maltreatment and recent and ongoing contextual stress/abuse, higher levels of cumulative exposure to racial/ethnic discrimination are associated with higher levels of depressive symptoms within nonpregnant adolescents [22,23] and pregnant adults [21 ▪ ,24]. Additional work is needed to replicate these associations within samples constituted solely of adolescents who are pregnant.…”

Section: Predisposing Risk Factorsmentioning

confidence: 99%

Depressive symptomatology in pregnant adolescents: considerations for care

Wittenberg

Fitzgerald

Pluhar

2023

Current Opinion in Pediatrics

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Purpose of review Adolescents who are pregnant experience higher levels of depressive symptoms than nonpregnant peers and pregnant adults. Clinicians caring for youth are often the first point of clinical contact for pregnant adolescents but report low confidence in assessing and treating reproductive health concerns. In the current review, we outline risk factors for depressive symptoms among pregnant adolescents and provide guidance on best practices in assessment and treatment of depressive symptoms in this pediatric sub-population. Recent findings Depressive symptoms are persistent across pregnancy. In adolescents, they are linked to greater risk of suicidal ideation, suicidal behavior, and nonsuicidal self-injury. Risk factors for prenatal depressive symptoms among adolescents include lower levels of income, history of depression, exposure to childhood maltreatment and/or recent abuse, and/or lifetime exposure to racial/ethnic discrimination. These risk factors likely interact with each other. Summary Clinicians should assess carefully for depressive symptoms in all pregnant adolescents using a standardized, validated measure supplemented by thoughtful clinical interviewing. Clinicians can educate adolescents on the distinction between symptoms of pregnancy versus symptoms of depression. We encourage clinicians to increase their comfort in providing psychopharmacological treatment, consulting with colleagues in psychiatry, and referring adolescents for psychopharmacological treatment and therapy as needed.

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Section: Predisposing Risk Factorsmentioning

confidence: 99%

Depressive symptomatology in pregnant adolescents: considerations for care

Wittenberg

Fitzgerald

Pluhar

2023

Current Opinion in Pediatrics

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“…Importantly, efforts to decrease institutional and interpersonal experiences of racial/ethnic discrimination and gendered structural racism would tremendously benefit the healthcare service and sleep quality of pregnant AAW, [ 205 , 212 – 215 ] particularly during early pregnancy. [ 124 ]…”

Section: Pregnancy and Inflammatory Bowel Disease Care Coordination T...mentioning

confidence: 99%

Managing Pregnancy and Nursing Affecting African American Women with Inflammatory Bowel Disease: Clinical Outcomes and Parenthood

M’Koma¹,

Ware²,

Nabaweesi³

et al. 2023

MRAJ

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Inflammatory bowel disease (IBD) is a term for two autoimmune diseases encompassing Crohn’s disease (CD) and ulcerative colitis (UC) which are lifelong diseases affecting more than 3 million adults (1.3%) in the United States. IBD is characterized by chronic inflammation of the whole digestive system which results in damage to the gastrointestinal (GI) tract. IBD often emerges during adolescence and young adulthood. Maternal morbidity includes physical and psychological conditions that result from or are aggravated by pregnancy and have an adverse effect on a woman’s health, the baby’s health or both. Some women have health challenges that arise before or during pregnancy that could lead to complications. It is recommended for women to receive health care counseling before and during pregnancy. Compared to other developed countries, the United States has the highest rate of women dying of pregnancy related complications. During the past 25 years maternal mortality has been getting worse. African American women (AAW) with and/or without IBD are dying at significantly higher rates than other groups. This is linked to several factors, i.e., systemic, institutionalized, and structural racism in health-care delivery and subsequent toxic stress from people’s lived experiences of racism, limited knowledge about healthcare system function, lack of access to healthcare, (inclusiveness and insurance policies) all of which negatively impact these patients. African Americans (AAs) are also up to three times as likely to experience severe maternal morbidity: unexpected outcomes of labor and delivery, deficient or lacking prenatal care and social determinants of health like lack of transportation, adequate employment, limited literacy, and limited healthcare access contribute to poor health outcomes. Studies on IBD patients indicate Medicaid expansion is associated with reduced rates of maternal morbidity, particularly for African American Women (AAW) and increased access to preconception and prenatal services that make pregnancy and childbirth safer for parent and baby. Herein we examine the physiological changes of pregnancy in patients diagnosed with inflammatory bowel disease and their relationship perinatal outcomes and parenthood.

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“…Participants reported their lifetime experiences of racial and ethnic discrimination as well as gendered racial stress during early pregnancy and reported their sleep quality and depressive symptoms during early and mid-pregnancy. The findings showed that greater exposure to racial and ethnic discrimination is associated with poorer sleep quality during early and mid-pregnancy (Cohen et al, 2022). Likewise, greater gendered racial stress was associated with poorer sleep quality during early and mid-pregnancy (Cohen et al, 2022).…”

Section: Societal-level Factorsmentioning

confidence: 86%

“…The detrimental impact caused by racism and discrimination on sleep during pregnancy is concerning in the larger context of the health of the mother and child dyad. Measured by the Experiences of Discrimination Scale , heightened exposure to racial/ethnic discrimination is associated with poorer overall sleep health (Cohen et al, 2022), as well as poorer sleep initiation, sleep maintenance, and daytime function during the perinatal period . When women reported their experiences of gendered racial stress using the Jackson, Hogue, Phillips Contextualized Stress questionnaire (Jackson et al, 2005), greater exposure to racial/ethnic discrimination, as well as more significant gendered racial stress, were found to be associated with poorer sleep quality during early and mid-pregnancy (Cohen et al, 2022).…”

Section: Social and Societal-level Factorsmentioning

confidence: 99%

“…Measured by the Experiences of Discrimination Scale , heightened exposure to racial/ethnic discrimination is associated with poorer overall sleep health (Cohen et al, 2022), as well as poorer sleep initiation, sleep maintenance, and daytime function during the perinatal period . When women reported their experiences of gendered racial stress using the Jackson, Hogue, Phillips Contextualized Stress questionnaire (Jackson et al, 2005), greater exposure to racial/ethnic discrimination, as well as more significant gendered racial stress, were found to be associated with poorer sleep quality during early and mid-pregnancy (Cohen et al, 2022). Additionally, the more experiences of racial discrimination Black pregnant women reported on the Experiences of Discrimination Scale, the more likely participants were to report decreased psychological well-being (Giurgescu et al, 2017).…”

Section: Social and Societal-level Factorsmentioning

confidence: 99%

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Understanding sleep deficiencies during pregnancy for Black women

Tibbitt

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Sleep deficiencies during pregnancy are associated with adverse maternal and fetal outcomes. Black pregnant women are disproportionately affected by sleep deficiencies. Yet, the upstream factors contributing to their sleep deficiencies and their coping strategies for their sleep deficiencies are understudied in the literature. This qualitative study, guided by the socialecological framework, aimed to understand the experience of sleep deficiencies during pregnancy for Black women and the coping strategies they employ to mitigate these deficiencies.In-depth, semi-structured, open-ended interviews were conducted with Black pregnant women.Interviews were analyzed through thematic analysis. Five major themes emerged from the findings: (1) Motherwork and Collective Care, (2) Protected Sleep, (3) Inadequate Support from the Healthcare Team, (4) Creating Peace and Calm, and (5) Psychological Safety. A focus group was conducted with participants to validate the findings. Findings highlight the need for healthcare providers to assess for sleep deficiencies regularly throughout pregnancy, with consideration for Black women. It is recommended that culturally relevant, patient-centered interventions be developed through future research.

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Discrimination is associated with poor sleep quality in pregnant Black American women

Cited by 12 publications

References 75 publications

Depressive symptomatology in pregnant adolescents: considerations for care

Depressive symptomatology in pregnant adolescents: considerations for care

Managing Pregnancy and Nursing Affecting African American Women with Inflammatory Bowel Disease: Clinical Outcomes and Parenthood

Understanding sleep deficiencies during pregnancy for Black women

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