Stress of Racism May Lead to Low Birthweight Babies

Source: Pace News

Researchers have long been puzzled about why African-American women are much more likely than whites to deliver premature and underweight babies.

Factors such as genetics, unequal prenatal care and poverty only partly explain why blacks are three times more likely to deliver very low birthweight babies (less than 3.3 pounds). For example, a substantial black-white gap persists even among mothers who have college degrees. Two studies published Monday in the American Journal of Public Health lend support to a new explanation: The psychological stress of experiencing racial discrimination is at least partly responsible for premature and low birthweight babies. Duke University researcher Sarah Mustillo and colleagues analyzed births in Chicago, Oakland, Minneapolis and Birmingham, Ala. Among black women, 50 percent of those with preterm deliveries and 61 percent with low birthweight babies had experienced discrimination in at least three situations. Among white women, the corresponding rates of racial discrimination were 5 percent and zero percent. In a second study, researchers asked 312 black women who delivered babies at Stroger and University of Chicago hospitals whether they had experienced discrimination looking for work, at work, at school, in public settings or while getting medical care. Those who had experienced discrimination in at least three settings were 2.6 times more likely to deliver very low birthweight babies.

"Chronic stress somehow leads to pre-term deliver," said Dr. James Collins of Children's Memorial Hospital and Northwestern University, lead author of the second study.

Researchers suggested several possible mechanisms:

• Discrimination-related stress might increase blood pressure, which can affect birth outcomes.
• Racism-related stress might trigger the release of a substance called corticotropin-releasing hormone, which has been linked to preterm deliveries.
• Human and animal studies have found that stress can suppress the immune system. Lowered immunity in turn can increase the risk of a mild bacterial infection of the vagina that has been linked to preterm births.

If further research shows racial discrimination is indeed the culprit, "then prenatal care by itself is not going to address the disparity, " Collins said. "It's a tenacious problem." However, health care providers perhaps could minimize the problem by talking about it to African -American women during pregnancy, organizing support groups and teaching skills to cope with discrimination and stress, Collins said.