Maternal Experiences with Everyday Discrimination and Infant Birth Weight: A Test of Mediators and Moderators Among Young, Urban Women of Color
By Jamie Scharoff
What do we already know?
There are pronounced racial and ethnic differences in birth weight among newborns in the United States. In 2009, the rate of low birth weight was 5.23% for White women, 5.72% for Latina women, and 11.44% for Black women. Low birth is associated with health problems among infants, and is one of the three leading causes of infant death. In adulthood, low birth weight is associated with diminished lung function and cardiovascular disease. Evidence suggests that being exposed to different types of discrimination can be related to poor health. Taking this one step further, these experiences of discrimination are linked to reports of depressive symptoms. When experienced by pregnant women, depressive symptoms can impact their infants’ birth weight.
What do we want to know?
Most past research on discrimination and disparities in birth outcomes had focused on African American women specifically. Earnshaw and colleagues wanted to investigate these associations among urban Latina and Black pregnant young women (aged 14-21). The purpose of the study was to examine the link between maternal discrimination and infant birth weight among young urban women of color. Mediators are variables that can explain why discrimination may be associated with birth weight. In this study, the researchers explored the mediators of depressive symptoms, pregnancy distress, and pregnancy symptoms, all variables that if experienced by the mother during pregnancy have the potential to cause increased likeliness of giving birth to a baby with a low birth weight. Moderators are variables that have the potential to affect the strength of the association between mothers’ experiences and the infants’ low birth weight. The moderators in this study were age and race/ethnicity, because they wanted to see if younger women for example were more vulnerable to the effects of discrimination than older women.
What did they do?
The researchers recruited pregnant young women aged 14-21, who were referred by health care providers between 2008 and 2011. Baseline interviews were conducted during their second trimester of pregnancy, second interviews were conducted during their third trimester, and final interviews were conducted 6 and then 12 months postpartum. During the participant interviews, everyday discrimination, depressive symptoms, pregnancy symptoms and pregnancy distress were measured. Information about the infants, including birth weight, was recorded from the infants’ birth records. 420 women were included in these analyses.
What did they find?
The researchers found that everyday discrimination experienced by pregnant women was associated with lower birth weight among their infants. In addition, measures of depressive symptoms were found to serve as a mediator to the relationship between lower birth weight and everyday discrimination. This means that when women who experienced everyday discrimination during their second trimester reported more depressive symptoms later on in their third trimester. In turn, women with more depressive symptoms had babies with lower birth weights. Women who experienced more discrimination reported more pregnancy distress and symptoms, but pregnancy distress and symptoms were not associated with infant birth weight.
Another important finding was that none of the moderators affected this relationship. Therefore, maternal everyday discrimination affected infant birth weight no matter the woman’s age or race/ethnicity. Although a relationship between everyday discrimination and birth weight was uncovered, on average participants reported experiencing everyday discrimination infrequently.
This research shows that exposure to everyday discrimination is impacting young urban women of color and their babies. These experiences of everyday discrimination coupled with depressive symptoms may lead to disparities in their children’s birth weights. When these children are born with low birth weight it puts them at risk for life-long health complications such as infant death, chronic lung disease and even cardiovascular disease in adulthood. Experiences of everyday discrimination and depressive symptoms in young urban women of color need to be addressed. Treating these depressive symptoms could help to lessen the impact that discrimination has on their children’s birth weight. Finding ways to eliminate discrimination so that no women experience it is also critically important.
Reference: Earnshaw, V.A., Rosenthal, L., Lewis, J.B., Stasko, E.C., Tobin, J.N., Lewis, T.T., Reid, A.E., & Ickovics, J.R. (2013). Maternal experiences with everyday discrimination and infant birth weight: a test of mediators and moderators among young, urban women of color. Annals of Behavioral Medicine, 45(1), 13-23.