(108) Changes in discrimination across the peripartum period and associations with birth outcomes for Black women

Thursday, February 9, 2023

10:30 AM – 12:00 PM

Objective: Structural racism and discrimination have been shown to contribute to racial inequities in birth outcomes between Black and White women, but less is known about variability in these associations that could better inform preventive interventions. Our goals were to determine whether self-reported experiences of discrimination changed as a function of pregnancy for a sample of primiparous Black women, and whether such changes were associated with offspring birthweight and gestational age at birth.

Study Design: Data were drawn from the 21-year longitudinal Pittsburgh Girls Study (PGS); a representative, urban-living population sample of 2,450 women (52% Black, 33% receiving public assistance), in which births have been tracked since age 12. By PGS wave 19, N= =290 Black women had become first-time mothers and had reported on discrimination experiences across five timepoints: during the two-years preconception (T-2, T-1), pregnancy (T), and two years postpartum (T+1, T+2). These participants were matched pairwise on race, cohort and experiences of discrimination with 290 never-pregnant PGS participants. Birth outcomes were obtained from electronic health records or self-report.

Results:

Latent growth curve models showed good model fit (RMSEA=0.042, CFI=.986/TLI=0.984) and significant variance around the intercept and slope of discrimination. Over the five-year period, the childbearing group showed an increasing rate of discrimination experiences (β = -0.252, S.E.= 0.102, p < .02). Experiences of discrimination at two years preconception also predicted lower offspring birthweight (β = 0.263, S.E.= 0.129, p < .05).

Conclusion: Black women experience heightened discrimination during the peripartum period as a function of pregnancy and childbirth. Experiences of discrimination, even before conception, have the potential to impact birth outcomes.

Primary & Presenting Author(s)

Alison E. Hipwell, BSc, MA, PhD
Professor of Psychiatry and Psychology
University of Pittsburgh
Pittsburgh, Pennsylvania, United States

Coauthor(s)

KM
Kesley Magee, PhD
University of Pittsburgh
Pittsburgh, Pennsylvania, United States
IT
Irene Tung, PhD
California State University Dominguez Hills
Carson, California, United States
KK
Kate Keenan, PhD
University of Chicago
Chicago, Illinois, United States
ML
Michele Levine, PhD
University of Pittsburgh
Pittsburgh, Pennsylvania, United States