Racial/ethnic disparities in self-reported psychosocial measures during pregnancy

Cora B. Parker; Shannon Michelle Hunter; W Grobman; Corette Parker; M Esplin; C-L Nhan-Chang; H Simhan; S Parry; D Wing; B Mercer; D Haas; Shannon Michelle Hunter; R Silver; M Hoffman; A Peaceman; S Caritis; J Ludmir; P Wadwha; J Iams; E Perkins; G Saade; M Willinger; U Reddy

Racial/ethnic disparities in self-reported psychosocial measures during pregnancy

Grobman, W., Parker, C., Esplin, M., Nhan-Chang, C-L., Simhan, H., Parry, S., Wing, D., Mercer, B., Haas, D., Hunter, S., Silver, R., Hoffman, M., Peaceman, A., Caritis, S., Ludmir, J., Wadwha, P., Iams, J., Perkins, E., Saade, G., ... Reddy, U. (2015). Racial/ethnic disparities in self-reported psychosocial measures during pregnancy. American Journal of Obstetrics and Gynecology, 212(1, Suppl), S256. https://doi.org/10.1016/j.ajog.2014.10.556

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Abstract

Objective To determine whether there are racial/ethnic differences in self-reported psychosocial measures during pregnancy and whether these differences are affected by economic status. Study Design This analysis is derived from a study of 10,037 nulliparous women who were prospectively followed throughout pregnancy. All women completed several validated surveys in the first or second trimester, including those that measured Depression (D), Experiences of Racism (R), Perceived Stress (PS), Pregnancy Experiences hassles/uplifts intensity (PE), Trait Anxiety (TA), and Social Support (SS). Women were categorized according to whether their D score ? 10, their R score ? 3, or other survey scores were in the lowest quartile. It was determined (1) whether race/ethnicity (defined as Non-Hispanic White (NHW), Non-Hispanic Black (NHB), Hispanic (H), Asian (A) or Other (O)) was associated with the elevated D or R scores or scores in the lowest quartile and (2) whether any observed association was affected by low income (defined as <= 200% of the poverty level). Results 8129 women had survey, race/ethnicity, and poverty data available and were included in the analysis. For all measures, race/ethnicity was significantly associated (P<.001) with survey scores, with NHB women being most likely to score in the worst category for all measures (Table). The magnitude of these differences did not differ by income status (income x race interaction, p >.05) with the exception of R, which was exacerbated among NHB women with higher income (income x race interaction, p < .001). Conclusion There are significant racial/ethnic disparities, independent of income status, with regard to psychosocial measures during pregnancy. The relationship of these disparities to the disparities in adverse pregnancy outcomes such as preterm birth requires further investigation.