The 131st Annual Meeting (November 15-19, 2003) of APHA

The 131st Annual Meeting (November 15-19, 2003) of APHA

5169.0: Wednesday, November 19, 2003 - 3:42 PM

Abstract #61991

Understanding the persistent racial disparity in adverse birth outcomes using an expanded model of stress

Tyan Parker Dominguez, MSW, MPH, PhD1, Christine Dunkel Schetter, PhD2, Laura Glynn, PhD3, Calvin J. Hobel, MD4, and Curt A. Sandman, PhD3. (1) School of Social Work, University of Southern California, Montgomery Ross Fisher Building, Room 208, Los Angeles, CA 90089-0411, (213) 740-2765,, (2) Department of Psychology, University of California, Los Angeles, 1282A Franz Hall, Box 951563, Los Angeles, CA 90095-1563, (3) Department of Psychiatry and Human Behavior, University of California, Irvine, 2501 Harbor Blvd. #7, Costa Mesa, CA 92626, (4) Department of Maternal/Fetal Medicine, Cedars-Sinai Medical Center, 8635 West 3rd Street, 160W, Los Angeles, CA 90048

This project was concerned with whether the persistent racial disparity in adverse birth outcomes could be explained by racial differences in various types of stress. The traditional model used to study stress and pregnancy was expanded to include exposure to individual and sociostructural forms of racism-related stress occurring at any point in the respondentís lifetime. Research questions included: 1) Are there racial differences in stress? in birth outcomes? 2) Is stress predictive of birth outcomes? and 3) Do the racial differences in stress account for the racial differences in birth outcomes? These questions were examined in a sample of 51 pregnant African-American and 73 pregnant White women using a prospective, repeated measures survey design to collect data three times prenatally on general psychosocial stress, pregnancy-related stress, racism-related stress, and medical/health and sociodemographic risk factors. Birth outcomes of interest were birthweight and gestational age. Race, SES, SLEs, interpersonal racism, and socioeconomic subordination were predictors of birthweight. Medical risk, SLEs, perceived stress, and socioeconomic subordination were predictors of gestational age. There were no significant race by stress interactions for the prediction of birthweight or gestational age, controlling for confounders. There was evidence that both interpersonal racism and residential segregation were mediators of the race/birthweight relationship. This project underscores the importance of racism-related stress for the psychological and physical health of pregnant women. Further research with larger samples and more refined measures of racism-related stress are necessary to assess the replicability of these findings.

Learning Objectives:

Keywords: Health Disparities, Stress

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Project was a collaboration of investigators from University of California at Irvine, University of California at Los Angeles, and Cedars-Sinai Medical Center. It was funded by NIH.
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Racial Disparities in Maternal and Child Health

The 131st Annual Meeting (November 15-19, 2003) of APHA