Racial/ethnic differences in self-reported and biologic measures of chronic stress in pregnancy

Abstract

ObjectiveRacial differences in chronic maternal stress may contribute to disparities in pregnancy outcomes. The objective is to identify racial and ethnic differences in self-reported and biologic measures of stress between non-Hispanic black (NHB) and non-Hispanic white (NHW) pregnant women.Study DesignNHB and NHW pregnant women were enrolled prior to 23 weeks gestation in this prospective cohort study. Equal numbers of women were recruited with public versus private insurance in each racial group. Self-reported stress was measured and blood samples collected in the 2nd and 3rd trimesters were analyzed for serum Epstein - Barr virus (EBV) antibody, C - reactive protein (CRP), corticotropin-releasing hormone (CRH), and adenocorticotropic hormone (ACTH).Results112 women were enrolled. NHW women reported more buffers against stress (p=0.04) and neighborhood satisfaction (p=0.02). NHB women reported more discrimination (p<0.001), food insecurity (p=0.04) and had significantly higher mean CRP levels and mean ACTH levels in the 2nd and 3rd trimesters.ConclusionSignificant differences in self-reported and biologic measures of chronic stress were identified between NHB and NHW pregnant women with similar economic characteristics. Future studies should investigate mechanisms underlying these differences and their relationship to pregnancy outcomes.

Negative health outcomes associated with food insecurity status in the United States of America: A systematic review of peer-reviewed studies

“…The studies used a diverse group of questionnaires for measuring FIS and anxiety, with one study directly measuring cortisol levels. The effect of FIS on anxiety was shown in preschool children (51), pregnant women (52,53), general public visiting the emergency department (ED)(54), diabetic patients (55,56), Hispanic adults (57), and college freshmen (58).…”

Household food insecurity associated with gestacional and neonatal outcomes: a systematic review

“…In pregnancy, some aspects of a woman's life may play a major role during the gestational period and for neonatal outcomes, especially in adverse social contexts [10,11]; such effects were estimated to occur for approximately 70% of pregnant women in Nigeria [12] In this sense, FI can be an important variable for the presence or aggravation of stressful pregnancy events by compromising access to sufficient and quality food, as well as increasing clinical complications during pregnancy and childbirth and in newborns [8,13,14]. Some relationships of FI with pregnancy have been documented in previous studies, such as associations of FI with overweight in mothers [5], low birth weight [15], low weight in children, inadequate development, overweight, impaired cognitive development, and behavioural and emotional factors [16][17][18][19].…”

Contribution of Socioeconomic Status to Racial/Ethnic Disparities in Adverse Pregnancy Outcomes Among Women With Systemic Lupus Erythematosus

“…Despite the small sample sizes for minority women, the 3‐fold higher odds of APO in whites and 6‐fold higher odds in African Americans remained significant after adjustment of SES. These results suggest that the association of race/ethnicity in this group is explained by other factors, such as genetics, increased stress levels, and shorter placental telomere length .…”