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Racial Disparities in Adverse Pregnancy Outcomes and Psychosocial Stress
Open accessAbstract
OBJECTIVE: To assess the relationships between self-reported psychosocial stress and preterm birth, hypertensive disease of pregnancy, and small-for-gestational-age (SGA) birth and to assess the extent to which these relationships account for racial and ethnic disparities in these adverse outcomes. METHODS: Self-reported measures of psychosocial stress (perceived stress, depression, racism, anxiety, resilience, and social support) were collected during pregnancy among a racially and ethnically diverse cohort of women enrolled in a prospective observational study of nulliparous women with singleton pregnancies, from eight clinical sites across the United States, between October 2010 and May 2014. The associations of preterm birth, hypertensive disease of pregnancy, and SGA birth with the self-reported measures of psychosocial stress as well as with race and ethnicity were evaluated. RESULTS: The study included 9,470 women (60.4% non-Hispanic white, 13.8% non-Hispanic black, 16.7% Hispanic, 4.0% Asian, and 5.0% other). Non-Hispanic black women were significantly more likely to experience any preterm birth, hypertensive disease of pregnancy, and SGA birth than were non-Hispanic white women (12.2% vs 8.0%, 16.7% vs 13.4%, and 17.2% vs 8.6%, respectively; P <.05 for all). After adjusting for potentially confounding factors, including the six different psychosocial factors singly and in combination, non-Hispanic black women continued to be at greater risk of any preterm birth and SGA birth compared with non-Hispanic white women. CONCLUSION: Among a large and geographically diverse cohort of nulliparous women with singleton gestations, non-Hispanic black women are most likely to experience preterm birth, hypertensive disease of pregnancy, and SGA birth. These disparities were not materially altered for preterm birth or SGA birth by adjustment for demographic differences and did not appear to be explained by differences in self-reported psychosocial factors.
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“Additionally, 67% of participants identified as White, which limits generalizability to non-Hispanic Black people, who have a higher risk for obstetric complications including HDP than White pregnant people.36”
From Prenatal Mindfulness Training and Interoceptive Awareness in Pregnant People at Risk for Hypertensive Disorders. (2024) · cites this paper as [36]
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Metadata
- Authors
- Grobman, W. A., Parker, C. B., Willinger, M., Wing, D. A., Silver, R. M., Wapner, R. J., Simhan, H. N., Parry, S., Mercer, B. M., Haas, D. M., Peaceman, A. M., Hunter, S., Wadhwa, P., Elovitz, M. A., Foroud, T., Saade, G., Reddy, U. M., & for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b) Network*
- Affiliations
- Northwestern University (US)
- ORCID
- Venue
- Obstetrics & Gynecology
- Published
- 2018-02
- Volume
- 131
- Issue
- 2
- Pages
- 328-335
- ISSN
- 0029-7844 (ISSN-L)
- PMC
- PMC5785441
- OpenAlex
- W2783803193
- Cited by
- 260
- References
- 22
- Citations by year
- 2026: 17 · 2025: 29 · 2024: 27 · 2023: 41 · 2022: 56 · 2021: 45 · 2020: 28 · 2019: 10 · 2018: 5
- FWCI
- 20.82
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- University of Pennsylvania (U10 HD063046, U10 HD063020, U10 HD063047, U10 HD063041, U10 HD063072, U10 HD063036, U10 HD063053, U10 HD063037, U10HD063048)
- Northwestern University (U10 HD063053, U10 HD063020, U10 HD063046, U10 HD063048, U10 HD063072, U10 HD063036, U10 HD063047, U10 HD063037, U10 HD063041)
- National Institute of Child Health and Human Development
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (U10HD063053, U10HD063046, U10HD063020, U10HD063072, HD063036, U10HD063048, U10HD063041, U10HD063047, U10HD063036, U10HD063037, UG1HD040512)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Keywords
- racial disparities, psychosocial stress, preterm birth, hypertensive disorders of pregnancy, small-for-gestational-age birth, non-Hispanic Black women, nulliparous women, perceived stress, racism, depression, anxiety, resilience, social support, pregnancy outcomes
- MeSH terms
- Adult, Ethnicity, Female, Humans, Infant, Newborn, Infant, Small for Gestational Age, Pregnancy, Pregnancy Outcome, Prospective Studies, Stress, Psychological, White People, Hypertension, Pregnancy-Induced, Premature Birth, Health Status Disparities, Self Report
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