Perceived Discrimination and Depressive Symptoms, Smoking, and Recent Alcohol Use in Pregnancy

Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Birth (Impact Factor: 1.26). 06/2010; 37(2):90-7. DOI: 10.1111/j.1523-536X.2010.00388.x
Source: PubMed


Perceived discrimination is associated with poor mental health and health-compromising behaviors in a range of vulnerable populations, but this link has not been assessed among pregnant women. We aimed to determine whether perceived discrimination was associated with these important targets of maternal health care among low-income pregnant women.
Face-to-face interviews were conducted in English or Spanish with 4,454 multiethnic, low-income, inner-city women at their first prenatal visit at public health centers in Philadelphia, Penn, USA, from 1999 to 2004. Perceived chronic everyday discrimination (moderate and high levels) in addition to experiences of major discrimination, depressive symptomatology (CES-D >or= 23), smoking in pregnancy (current), and recent alcohol use (12 months before pregnancy) were assessed by patients' self-report.
Moderate everyday discrimination was reported by 873 (20%) women, high everyday discrimination by 238 (5%) women, and an experience of major discrimination by 789 (18%) women. Everyday discrimination was independently associated with depressive symptomatology (moderate = prevalence ratio [PR] of 1.58, 95% CI: 1.38-1.79; high = PR of 1.82, 95% CI: 1.49-2.21); smoking (moderate = PR of 1.19, 95% CI: 1.05-1.36; high = PR of 1.41, 95% CI: 1.15-1.74); and recent alcohol use (moderate = PR of 1.23, 95% CI: 1.12-1.36). However, major discrimination was not independently associated with these outcomes.
This study demonstrated that perceived chronic everyday discrimination, but not major discrimination, was associated with depressive symptoms and health-compromising behaviors independent of potential confounders, including race and ethnicity, among pregnant low-income women.

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Available from: David A Webb, Mar 17, 2014
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    • "There is ample evidence in the literature denoting the association of discrimination, whether direct, indirect, or at the population level, with adverse health status and health outcomes.27–31 Perceived racial and ethnic discrimination in childhood has been shown to have negative effects on health,30,31 including lower self-rated physical health as adults32; preterm birth, low birth weight, and very low birth weight32,33; and depressive symptoms,34 among others. Addressing inequities in neighborhood and social environments would improve health and thus decrease health disparities. "
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