Predicting low birthweight and complicated labor in urban black women: A biopsychosocial perspective (original) (raw)
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Psychosocial Factors and Birth Outcome: African American Women in Case Management
Journal of Health Care for the Poor and Underserved, 1998
The relationship between psychosocial risk factors and birth outcomes among African American pregnant women is explored. The study focuses on social/environmental stressors and proposes a workable model for delivery of services based on case management principles. Unstable income, perinatal medical problems, alcohol use, smoking, access to prenatal care, internal barriers to care, compliance problems, negative experiences with providers, depression, unresolved grief, and fetal substance exposure were significantly associated with low birthweight. Unstable income, compliance problems, internal banters to care, and poor access to care were significantly associated with preterm delivery. Specific interventions aimed at providing social support, facilitating access to care, health education, and encouragement to verbalize feelings about problems were significantly associated with the number of problems that the client was able to solve. The data indicated the importance of psychosocial, environmental, and medical risk factors in the prediction of low birthweight and preterm delivery in a high-risk population.
Maternal and Child Health Journal, 2001
This special issue of the Maternal and Child Health Journal largely results from a 1999 conference sponsored by the Centers for Disease Control and Prevention (CDC) titled "The Social Context of Pregnancy Among African American Women: Implications for Preterm Delivery Prevention." During this conference, results of qualitative and quantitative research were presented to identify potential new explanatory risk factors for adverse pregnancy outcomes and to better understand how known factors interact among women in the real world. Knowledge of the social context of African American women's lives, in particular, along with improved understanding of the etiology of preterm birth can generate new perspectives for future research and new interventions to reduce racial and ethnic disparities in preterm delivery. While other publications have contributed to our understanding of medical and biologic factors influencing pregnancy outcome, this issue focuses on furthering our understanding of the social factors influencing pregnancy outcome.
The effects of stress on birth weight in low-income, unmarried Black women
Women's Health Issues, 2009
Objective. Low birth weight leads to adverse health outcomes throughout life, is particularly high among Blacks, and may contribute to health disparities between Whites and Blacks in the United States. Stress is among the many potential contributors to birth weight, but key sources of stress have not yet been clearly identified. The objective of this paper is to describe the relationships between multiple sources of maternal stress and birth weight.
Psychological Bulletin, 2005
Compared with European Americans, African American infants experience disproportionately high rates of low birth weight and preterm delivery and are more than twice as likely to die during their 1st year of life. The authors examine 5 explanations for these differences in rates of adverse birth outcomes: (a) ethnic differences in health behaviors and socioeconomic status; (b) higher levels of stress in African American women; (c) greater susceptibility to stress in African Americans; (d) the impact of racism acting either as a contributor to stress or as a factor that exacerbates stress effects; and (e) ethnic differences in stress-related neuroendocrine, vascular, and immunological processes. The review of literature indicates that each explanation has some merit, although none is sufficient to explain ethnic disparities in adverse birth outcomes. There is a lack of studies examining the impact of such factors jointly and interactively. Recommendations and cautions for future research are offered.
Annals of Behavioral Medicine, 2005
Background: The persistently higher rates of adverse birth outcomes among African American women are a major public health concern. Purpose: The purpose of this study was to explore the relations among psychosocial stress, socioeconomic status, and birth outcomes in African American women. Methods: A prospective survey research design was used to measure stress exposure, subjective responses to stressors, including intrusive effects of life events, and medical and sociodemographic variables in a sample of 178 pregnant African American women. Birth outcomes were obtained from medical charts. Results: Life event exposure was high, but levels of perceived stress and negative emotional responses were low to moderate. Lower income African American women reported significantly greater pregnancy undesirability than higher income African American women. Educational attainment was not related to any of the stress variables, and neither income nor educational attainment was significantly related to birth outcomes. Number of stressful life events significantly predicted 3% additional variance in gestational age after controlling for potential confounders. Psychosocial stress variables altogether accounted for 7% additional variance in gestational age-adjusted birth weight, with event distress and intrusive thoughts concerning severe life events emerging as the significant independent stress predictors. Conclusions: These results contribute to our understanding of the complex etiological processes involved in African American birth outcomes and set the stage for further research into their reproductive health status.
Depressed pregnant black women have a greater incidence of prematurity and low birthweight outcomes
Infant Behavior and Development, 2009
Pregnant black depressed women were compared to pregnant black non-depressed women on self-report stress measures and cortisol levels at mid and late pregnancy and on neonatal outcomes. The depressed women had higher anxiety, anger, daily hassles, sleep disturbance scores and cortisol levels at both prenatal visits. These higher stress levels may have contributed to the greater incidence of prematurity and low birthweight neonatal outcomes noted in the depressed group, and they may partially explain the higher rate of prematurity and low birthweight among black women.
Social Work in Public Health, 2011
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