Racial/ethnic differences in the experience of stressful life events during pregnancy: Data from the Indiana Access project

Stress may play a role in racial/ethnic disparities in birth outcomes. The purpose of this study was to better understand the occurrence of stressful life events (SLE) in a sample of urban, low-income women and to study the association between race/ethnicity and the experience of SLE.

Through the Indiana Access project, 525 women in Indianapolis participated in face-to-face interviews during their post-partum hospitalization. Thirteen validated questions from PRAMS regarding SLE were included in the 162 item interview. Data for 93% of participants (n=493) were matched and augmented with select birth certificate data including demographic characteristics and socioeconomic status. The SLE questions were grouped into 4 constructs (emotional, financial, partner-related, traumatic) cited in the literature. Odds ratios were calculated to determine whether there was a relationship between race/ethnicity and the experience of SLE after controlling for mother's age, educational level and marital status.

Women of Latino, Native-American, Asian, or other ethnicity were 70% less likely to experience emotional stress (OR=0.3; 95% CI=0.2, 0.6) than Caucasian women. African-American women were 1.5 times more likely to experience both partner-related (OR = 1.5; 95% CI=1.0, 2.2) and traumatic (OR = 1.5; 95% CI=1.0, 2.2) stress than Caucasian women. Race/ethnicity was not associated with financial stress.

The results from this study can only be generalized to urban women of low socioeconomic status (Medicaid recipient or equivalent). Understanding the types of stressors low-income minority women are likely to experience is important in informing the development of interventions that might mitigate the impact of those stressors.