Racial/ethnic inequities in low birth weight and preterm birth: the role of multiple forms of stress

Almeida, Joanna, Bécares, Laia, Erbetta, Kristin, Bettegowda, Vani R and Ahluwalia, Indu B (2018) Racial/ethnic inequities in low birth weight and preterm birth: the role of multiple forms of stress. Maternal and Child Health Journal, 22 (8). pp. 1154-1163. ISSN 1092-7875

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Abstract

Introduction Racial/ethnic inequities in low birth weight (LBW) and preterm birth (PTB) persist in the United States. Research has identified numerous risk factors for adverse birth outcomes; however, they do not fully explain the occurrence of, or inequalities in PTB/LBW. Stress has been proposed as one explanation for differences in LBW and PTB by race/ethnicity. Methods Using the Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2012 to 2013 for 21 states and one city (n = 15,915) we used Poisson regression to estimate the association between acute, financial and relationship stressors and LBW and PTB, and to examine the contribution of these stressors individually and simultaneously to racial/ethnic differences in LBW and PTB. Results Adjusting for age and race/ethnicity, acute (p < 0.001), financial (p < 0.001) and relationship (p < 0.05) stressors were associated with increased risk of LBW, but only acute (p < 0.05) and financial (p < 0.01) stress increased risk of PTB. Across all models, non-Hispanic blacks had higher risk of LBW and PTB relative to non-Hispanic whites (IRR 1.87, 95% CI 1.55, 2.27 and IRR 1.46, 95% CI 1.18, 1.79). Accounting for the effects of stressors attenuated the risk of LBW and PTB by 17 and 22% respectively, but did not fully explain the increased likelihood of LBW and PTB among non-Hispanic blacks. Discussion Results of this study demonstrate that stress may increase the risk of LBW and PTB. While stressors may contribute to racial/ethnic differences in LBW and PTB, they do not fully explain them. Mitigating stress during pregnancy may help promote healthier birth outcomes and reduce racial/ethnic inequities in LBW and PTB.

Item Type: Article
Schools and Departments: School of Education and Social Work > Social Work and Social Care
Subjects: L Education
Depositing User: Deeptima Massey
Date Deposited: 10 Aug 2018 14:22
Last Modified: 10 Aug 2018 15:40
URI: http://sro.sussex.ac.uk/id/eprint/77716
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