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1.
J Perinat Neonatal Nurs ; 38(3): 334-341, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39074329

RESUMO

PURPOSE: The purpose of this study among pregnant and postpartum Black women was twofold: (1) to compare levels of perceived stress, depressive symptoms, social support, and neighborhood disorder and crime before the pandemic vs during the pandemic; and (2) to examine the association of perceived stress, depressive symptoms, and social support with neighborhood disorder and crime at both time points. METHODS: This was a prospective study as part of the Biosocial Impact on Black Births, a longitudinal study that examined the role of maternal factors on preterm birth among Black women. A sample of 143 women were included who responded to survey questions during pregnancy prior to the pandemic and again after birth, during the pandemic. Women completed the COVID survey between May 21, 2020, and January 28, 2021. RESULTS: The levels of perceived stress (70.75 and 76.28, respectively, P < .01) and social support (17.01 and 18.78, respectively, P < .01) were lower during the pandemic than prior to the pandemic. Social support, perceived stress, and depressive symptoms were significantly correlated with the pre-pandemic measures of perceived neighborhood disorder and crime. Perceived stress and depressive symptoms were also significantly correlated with pandemic measures of perceived neighborhood. CONCLUSION: Women reported lower levels of perceived stress during the pandemic than prior to the pandemic, but neighborhood characteristics were consistently associated with perceived stress and depressive symptoms both prior to and during the pandemic. Further exploration is warranted to better understand these relationships.


Assuntos
Negro ou Afro-Americano , COVID-19 , Características de Residência , Apoio Social , Estresse Psicológico , Humanos , Feminino , COVID-19/epidemiologia , COVID-19/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Gravidez , Adulto , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Estudos Prospectivos , Estudos Longitudinais , Depressão/epidemiologia , Depressão/psicologia , SARS-CoV-2 , Pandemias , Adulto Jovem
2.
J Perinat Neonatal Nurs ; 38(3): 256-270, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39074324

RESUMO

BACKGROUND: Black women in the United States report moderate to high levels of perceived stress during pregnancy. Though lower levels of involvement and support from father of the baby (FOB) and higher levels of conflict have been associated with higher levels of maternal perceived stress, it is not clear how Black pregnant women experience the mother-father relationship and its influence on perceived stress. PURPOSE: To examine and describe the mother-father relationship and its role in experiences of perceived stress from the perspective of Black pregnant women. METHODS: Using a convergent, mixed methods approach with ideal-type analysis, we conducted a secondary analysis of data among 60 Black pregnant women enrolled in the Biosocial Impact on Black Births study. Women completed online self-report questionnaires and participated in a semi-structured interview by telephone. RESULTS: Participants who reported more conflict with FOB also reported higher levels of perceived stress (ρ(47) = .431, P= .002). Themes (importance, communication, support, conflict, satisfaction, and stress) emerged from the data. Five distinct mother-father relationship typologies were identified following an ideal-type analysis of the combined dataset: Cared For; Managing Expectations; Just Friends, For the Kids; It's Complicated; and Can't be Bothered. CONCLUSIONS: These findings are an innovative exemplar of ideal-type analysis and provide a deeper understanding of the nuance and dynamics within the mother-father relationship and how it influences perceived stress among Black pregnant women. IMPLICATIONS: Clinicians must recognize the significance of the mother-father relationship and, when appropriate, encourage paternal involvement or intervene if there is conflict during pregnancy.


Assuntos
Negro ou Afro-Americano , Gestantes , Estresse Psicológico , Humanos , Feminino , Gravidez , Estresse Psicológico/psicologia , Adulto , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Gestantes/psicologia , Gestantes/etnologia , Estados Unidos , Apoio Social , Inquéritos e Questionários , Adulto Jovem , Relações Pai-Filho , Masculino
3.
Public Health Nurs ; 40(3): 372-381, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36740747

RESUMO

BACKGROUND: Neighborhood disadvantage may impact risk of preterm birth through stress. Few studies have examined how neighborhood disadvantage relates to stress during pregnancy, especially for Black women. METHODS: Secondary data analysis of 572 women in a prospective cohort in Detroit, MI and Columbus, OH. Participants completed questionnaires including the ROSS Neighborhood Disorder Scale, the crime subscale of the Perceived Neighborhood Scale (PNS), and the Perceived Stress Scale. An objective neighborhood disadvantage index (NDI) was created using principal components analysis after geocoding residential addresses and linking to Census data. RESULTS: All models used logistic regression. Adjusted for maternal age and annual household income, perceived stress was positively associated with perceived neighborhood disorder (p < .01). In a separate model, perceived neighborhood crime was positively associated with perceived neighborhood disorder (p = .005). In a joint model adjusted for age and income, the association of disorder with stress was similar in magnitude (p < .01) but the association between crime and stress weakened. The NDI was not associated with perceived stress before or after adjustment for confounders. CONCLUSIONS: Perceived neighborhood disadvantage may capture a different dimension than objective neighborhood disadvantage. Future studies should test stress as a pathway by which neighborhood environment increases risk of preterm birth.


Assuntos
Nascimento Prematuro , Gravidez , Feminino , Recém-Nascido , Humanos , Nascimento Prematuro/epidemiologia , Estudos Prospectivos , Negro ou Afro-Americano , Características de Residência , Inquéritos e Questionários , Características da Vizinhança
4.
J Urban Health ; 99(4): 692-700, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35668137

RESUMO

This study compares and contrasts residents' perceptions of segregation measures using qualitative and quantitative data. Most studies exploring racial residential segregation and health outcomes use large-scale, metropolitan-wide measures. As a result, we have limited understanding of racial residential segregation outside of Census data, particularly about the firsthand experiences of those living in segregated areas. The purpose of this study was to compare data from Census-based measures of racial residential segregation with qualitative descriptions of these same constructs by pregnant, Black women in two US cities. Using novel qualitative interview questions, we explored the dimensions of segregation and neighborhood racial distribution among a sample of 27 pregnant, Black women between April and November 2019. The participants included in this sample had perceptions about their neighborhood segregation and demographic composition that were often different from the data derived from existing residential US Census data. The differences between qualitative and quantitative measures and the possible reasons for the discordance suggest new approaches to measurement and new directions for the study of segregation and health.


Assuntos
Segregação Social , População Negra , Censos , Feminino , Humanos , Gravidez , Grupos Raciais , Características de Residência
5.
Dev Psychobiol ; 64(7): e22310, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36282764

RESUMO

Acculturative stress is unique among immigrants and refers to the stress associated with maintaining cultural values and traditions in the host country. Immigrant parents confront psychosocial variables such as acculturative stress, anxiety, and depression that might result in intergenerational negative consequences on their infants. Measurement of hair cortisol concentration (HCC), an outcome of neuroendocrine dysregulation, is one relatively noninvasive approach to gauge stress in infants. No published studies have evaluated associations among parents' psychosocial variables and infants' HCC among immigrant families. Therefore, the purpose of this study was to: (1) examine the relationship between maternal and paternal psychosocial stress variables; and (2) examine the association between psychosocial variables of both parents (acculturative stress, anxiety, and depression) and infants' HCC among immigrant Arab American families. A sample of 31 immigrant Arab American triads (mother-father-infant) was recruited. During one home visit, each parent completed the study questionnaires separately when the baby was 6-24 months old and a hair sample was collected from the infant for HCC. Parents reported significant symptoms of anxiety (33% mothers; 45% fathers) and depression (33% mothers; 35.5% fathers). Paternal acculturative stress, anxiety, and depressive symptoms were significantly correlated to infants' HCC. Acculturative stress, anxiety, and depressive symptoms were significantly correlated between mother-father dyads. Future research should continue to focus on immigrant families and include both parents to better understand and improve infant health.


Assuntos
Emigrantes e Imigrantes , Hidrocortisona , Lactente , Masculino , Feminino , Humanos , Pré-Escolar , Projetos Piloto , Árabes , Pai/psicologia , Mães/psicologia , Cabelo , Estresse Psicológico/psicologia , Depressão/psicologia
6.
J Perinat Neonatal Nurs ; 36(2): 161-172, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35476770

RESUMO

Pregnant women experienced disruptions in their prenatal care during the coronavirus disease-2019 (COVID-19) pandemic. While there is emerging research about the impact of COVID-19 on experiences of pregnancy, the majority of studies that have reported on prenatal care and birth during COVID-19 have not incorporated the first-person accounts of Black women. The purpose of this mixed-methods study was to explore the perspectives of Black women on prenatal care, labor, and birth during the pandemic. A total of 33 participants completed questionnaires. Fourteen of these 33 women and an additional 2 participated in qualitative interviews. Descriptive statistics and a mixed-methods analysis were employed. Participants expressed disappointment about disruptions in their experiences of pregnancy including the way their prenatal care was experienced, cancellation of planned "rites of passage," and visitor policy restrictions during and after the birth. Forty-five percent of participants reported being worried about getting COVID-19 and (61%) about their infant getting COVID-19. Many participants experienced a sense of loss that may permeate through other aspects of their lives. Providing extra support and points of contact can help lessen feelings of isolation during the pandemic and can also offer more explanation for rapidly changing policies and procedures.


Assuntos
COVID-19 , Pandemias , COVID-19/epidemiologia , Feminino , Humanos , Lactente , Masculino , Parto , Gravidez , Gestantes , Cuidado Pré-Natal/métodos
7.
Public Health Nurs ; 39(5): 917-925, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35238414

RESUMO

OBJECTIVE: To compare and contrast pregnant, Black women's voices with quantitative measures of racial residential segregation, neighborhood disorder, and racial discrimination. DESIGN AND SAMPLE: Using a convergent design for the parent study, surveys and qualitative interviews were completed by Black pregnant women (n = 27). MEASURES: Content analysis was conducted and data were analyzed to assess for congruency or divergence for each concept related to structural racism (racial residential segregation, neighborhood disorder, and discrimination). RESULTS: No single concept had 100% agreement across qualitative and quantitative approaches. Participants disclosed experiences during some interviews that were not captured by the surveys. The qualitative interviews offered a more detailed description of the concepts which along with the quantitative measures, provided insights about how participants perceived these mechanisms. DISCUSSION: While important relationships about the mechanisms of structural racism and preterm birth can be examined using a single approach, using mixed methods can offer more insights about how those most impacted by preterm birth relate to these mechanisms. Future work will best add to the understanding of structural racism and preterm birth when study measures accurately reflect the experiences of the people who experience racism.


Assuntos
Nascimento Prematuro , Racismo , Segregação Social , Negro ou Afro-Americano , Feminino , Humanos , Recém-Nascido , Gravidez , Gestantes , Características de Residência
8.
Public Health Nurs ; 39(4): 744-751, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35037297

RESUMO

OBJECTIVE: To examine aerobic physical activity (PA) among non-Hispanic Black pregnant women. DESIGN: Longitudinal prospective cohort study. SAMPLE: A subset of 161 non-Hispanic Black pregnant women from the Midwestern US participating in a larger study completed questionnaires about aerobic physical activity (PA) before pregnancy (reported at 24.46±2.13 weeks gestation), mid-pregnancy (24.46±2.13 weeks gestation), and late pregnancy (31.78±1.95 weeks gestation). MEASUREMENTS: Aerobic PA was measured using the Rapid Assessment of Physical Activity (RAPA). RESULTS: Most participants reported being active prior to pregnancy (n = 101, 63%), with 60 (37%) underactive/sedentary. Aerobic RAPA scores were highest pre-pregnancy (3.29±1.11, median = 4, interquartile range [IQR] = 1) compared with mid-pregnancy (3.05±1.26, median = 4, IQR = 2) and late pregnancy (3.05±1.24, median = 4, IQR = 2). Pre-pregnancy scores were significantly higher than mid-pregnancy scores (Wilcoxon test = 1472, p = .008) and late pregnancy scores (Wilcoxon test = 1854, p = .01). CONCLUSION: Most Black pregnant participants reported high levels of aerobic PA both before pregnancy and during pregnancy. However, many were underactive or sedentary. Aerobic PA decreased during pregnancy compared with pre-pregnancy, without the drop in third trimester PA found in other populations. Providers should assess PA across pregnancy and promote adequate PA for maternal and infant health, particularly among Black women.


Assuntos
Exercício Físico , Gestantes , Feminino , Humanos , Gravidez , Estudos Prospectivos , Inquéritos e Questionários
9.
Public Health Nurs ; 38(4): 596-602, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33844868

RESUMO

OBJECTIVE: This study explored stress and coping among pregnant Black women prior to and during the COVID-19 pandemic. DESIGN: Prospective, longitudinal, cohort study. SAMPLE: Thirty-three women enrolled in the Biosocial Impact on Black Births study prior to the COVID-19 pandemic and who were still pregnant during the pandemic. MEASUREMENTS: Questionnaires included the Perceived Stress Scale, Prenatal Coping Inventory, and questions related to sociodemographic characteristics, worry about COVID-19, and coping strategies used during the pandemic. RESULTS: Women reported very much being worried about my child getting COVID-19 (46%) and my family member getting COVID-19 (46%). Women reported specific active coping strategies very much reduced their feelings of discomfort during COVID-19: God, religion, or spirituality (24%), social media (24%), and following government advice (24%). Higher use of avoidance coping prior to the pandemic was associated with higher levels of stress both prior to (r = 0.60, p < .001) and during (r = 0.47, p < .01) the pandemic. CONCLUSION: Women reported worries about COVID-19 and used various strategies to cope with feelings of discomfort due to the pandemic. Nurses should assess the stress level of pregnant Black women and recommend active coping strategies during the pandemic.


Assuntos
Adaptação Psicológica , Negro ou Afro-Americano/psicologia , COVID-19/psicologia , Pandemias , Gestantes/etnologia , Estresse Psicológico/etnologia , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Ansiedade/etnologia , Ansiedade/psicologia , COVID-19/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Gravidez , Gestantes/psicologia , Estudos Prospectivos , Estresse Psicológico/enfermagem , Estresse Psicológico/psicologia , Inquéritos e Questionários , Estados Unidos/epidemiologia , Adulto Jovem
10.
Public Health Nurs ; 38(4): 555-563, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33590543

RESUMO

OBJECTIVES: We examine the mediation effects of prenatal stress on the associations between intimate partner violence (IPV) experience and the most common forms of substance use (i.e., cigarette smoking, alcohol drinking, and marijuana use) among pregnant Black women. DESIGN: Cross-sectional. SAMPLE: Black women (N = 203) from metropolitan Detroit, Michigan and Columbus, Ohio, were recruited between 8 and 29 weeks of gestation. MEASUREMENTS: Women were asked about IPV experience during 12 months prior to the start of the pregnancy, perceived stress during pregnancy, and substance use during pregnancy. RESULTS: Intimate partner violence prior to pregnancy was positively associated with cigarette smoking and marijuana use but not with alcohol use during pregnancy. IPV prior to pregnancy was also positively associated with higher levels of perceived stress during pregnancy after controlling for covariates. Path analysis indicated that IPV had an indirect effect on marijuana use through perceived stress (standardized indirect effect = 0.026, SE = 0.020, 95% CI = 0.005-0.064, p =.017). CONCLUSIONS: Perceived stress during pregnancy partially mediated the association between previous experience of IPV and marijuana use among pregnant Black women. Interventions are needed to reduce IPV that would lower stress during pregnancy and consequently substance abuse to improve pregnancy outcomes and maternal and newborn health.


Assuntos
Violência por Parceiro Íntimo , Transtornos Relacionados ao Uso de Substâncias , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Gravidez , Resultado da Gravidez , Gestantes
11.
J Urban Health ; 97(2): 271-278, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32095977

RESUMO

While evidence for neighborhood effects on adverse birth outcomes is growing, no studies have examined whether living in a neighborhood impacted by mass incarceration is associated with preterm birth risk. We used modified Poisson regression to test whether residence in a neighborhood impacted by mass incarceration predicted future risk of preterm birth, among African American women. We linked data from the Justice Atlas of Sentencing and Corrections to survey and medical record data from the Life-course Influences on Fetal Environments study (n = 681). We also tested for effect modification by age and marital status. The association between prison admission expenditures and future risk of PTB varied by maternal age at birth, with younger women (< 35) having a modest increase in risk (relative risk (RR) 1.07; 95% confidence interval (CI) 0.99, 1.15), and older (35+ year old) women having lower risk (RR 0.86; 95% CI 0.69, 1.07). The association between the number of prison admissions due to new court cases and future risk of PTB varied by marital status, with evidence that married women may be protected (RR 0.75; 95% CI 0.61, 0.92), while little evidence of association was observed among unmarried women (RR 1.02; 95% CI 0.80, 1.30). The association between residence in an area impacted by mass incarceration and future risk of PTB among African American women may vary by age and marital status. Future research to identify the mechanisms of these associations is warranted.


Assuntos
Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Gestantes/psicologia , Nascimento Prematuro , Prisioneiros/psicologia , Prisioneiros/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Adulto , Feminino , Humanos , Recém-Nascido , Michigan , Gravidez , Fatores de Risco , Adulto Jovem
12.
J Urban Health ; 97(1): 26-36, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31950324

RESUMO

Pregnant African American women who report higher levels of social disorder (e.g., vacant housing, drug dealing) in their neighborhoods also report higher levels of depressive symptoms. The effects of social disorder in the neighborhood during childhood on depressive symptoms during pregnancy are not known. Also unknown is the interaction between social disorders in the neighborhood during childhood and during pregnancy regarding depressive symptoms during pregnancy. The purpose of this study was to examine whether higher levels of social disorder in the neighborhood during pregnancy buffered the association of social disorder in the neighborhood during childhood (at age 10 as reference) with depressive symptoms during pregnancy among African American women. We conducted a secondary data analysis of 1383 African American women from the Life-course Influences on Fetal Environments (LIFE) Study (Detroit, Michigan, 2009-2011). Women were interviewed in the hospital 24-72 h after the births. The Center for Epidemiological Studies-Depression (CES-D) scale measured depressive symptoms. Scales measuring social disorder in the neighborhood both during childhood and during pregnancy were also included in the interviews. Women with CES-D scores ≥ 16 were younger, were more likely to be single, and had lower levels of education and household income compared with women with CES-D < 16. There was a significant association between women who report social disorder in their neighborhoods during childhood and depressive symptoms during pregnancy. This effect was moderated by measures of social disorder in the neighborhood during pregnancy (p = .037). Women who reported both low levels of social disorder in their neighborhoods during childhood and during pregnancy had the lowest CES-D scores after controlling for maternal age, marital status, years of education, and family income. The model had a good fit to the data (χ2(6) = 6.36, p = .38). Health care providers should inquire about neighborhood conditions during childhood and during pregnancy and provide referrals for appropriate professional and community support for women who report social disorder in their neighborhoods and depressive symptoms.


Assuntos
Experiências Adversas da Infância/estatística & dados numéricos , Negro ou Afro-Americano/psicologia , Depressão/etnologia , Características de Residência/estatística & dados numéricos , Condições Sociais/estatística & dados numéricos , Adolescente , Adulto , Criança , Feminino , Humanos , Michigan , Pessoa de Meia-Idade , Gravidez , Gestantes/etnologia , Apoio Social , Fatores Socioeconômicos , Adulto Jovem
13.
Public Health Nurs ; 37(5): 740-749, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32734603

RESUMO

OBJECTIVE: This study examined whether cigarette smoking mediated the association of racial discrimination with depressive symptoms among pregnant Black women. DESIGN: Cross-sectional. SAMPLE: Two hundred Black women at 8-29 weeks gestation. MEASUREMENTS: Women completed questionnaires including the Experiences of Discrimination and the Center for Epidemiologic Studies-Depression (CES-D) scales, as well as questions about sociodemographic characteristics and cigarette smoking. RESULTS: The mean age of the sample was 26.9 ± 5.7 years and the mean gestational age at data collection was 15.6 ± 5.7 weeks. Approximately 17% of women reported prenatal cigarette smoking; 27% had prenatal CES-D scores ≥23, which have been correlated with depression diagnoses; and 59% reported ever (lifetime) experiencing discrimination in at least one situation (e.g., at work). Path analysis results indicated that the standardized indirect effect of experiences of racial discrimination on CES-D scores through prenatal smoking was statistically significant (standardized indirect effect = 0.03; 95% CI: 0.001, 0.094; p = .042). CONCLUSION: Cigarette smoking during pregnancy partially mediated the association between lifetime experiences of racial discrimination and prenatal depressive symptoms among pregnant Black women. Smoking cessation programs should focus on identifying and treating depressive symptoms among pregnant Black women.


Assuntos
Negro ou Afro-Americano/psicologia , Fumar Cigarros/etnologia , Depressão/etnologia , Gestantes/etnologia , Racismo/psicologia , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Gravidez , Gestantes/psicologia , Inquéritos e Questionários , Adulto Jovem
14.
J Urban Health ; 96(2): 181-192, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30027428

RESUMO

The majority of studies investigating the relationship between racism/racial discrimination and birth outcomes have focused on perceived experiences of racism/racial discrimination directed at oneself (personal racism). However, evidence suggests individuals report with greater frequency racism/racial discrimination directed at friends, family members, or other members of their racial/ethnic group (group racism). We examined how much African American (AA) women report lifetime experiences of perceived racism or racial discrimination, both personal and group, varied by maternal age. We also investigated whether reports of personal and group racism/racial discrimination were associated with the risk of delivering a small-for-gestational age (SGA) infant and how much maternal age in relation to developmental life stages (adolescence [≤ 18 years], emerging adulthood [19-24 years], and adulthood [≥ 25 years]) moderated the relationship. Data stem from the Baltimore Preterm Birth Study, a hybrid prospective/retrospective cohort study that enrolled 872 women between March 2000 and July 2004 (analyzed in 2016-2017). Spline regression analyses demonstrated a statistically significant (p value for overall association < 0.001) and non-linear (p value = 0.044) relationship between maternal age and the overall racism index. Stratified analysis showed experiences of racism overall was associated with a higher odds ratio of delivering an SGA infant among AA women aged ≥ 25 years (OR = 1.45, 95% CI 1.02-2.08). The overall racism index was not associated with the SGA infant odds ratio for emerging adults (OR = 0.86, 95% CI 0.69-1.06) or adolescents (OR = 0.92, 95% CI 0.66-1.28). Multiple aspects of racism and the intersection between racism and other contextual factors need to be considered.


Assuntos
Negro ou Afro-Americano/psicologia , Etnicidade/psicologia , Idade Gestacional , Nascimento Prematuro/psicologia , Grupos Raciais/psicologia , Racismo/psicologia , Adolescente , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Fatores Etários , Baltimore , Etnicidade/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Razão de Chances , Gravidez , Estudos Prospectivos , Grupos Raciais/estatística & dados numéricos , Racismo/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
15.
Public Health Nurs ; 34(3): 256-266, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-27891658

RESUMO

OBJECTIVE: Prior research suggests that adverse neighborhood conditions are related to preterm birth. One potential pathway by which neighborhood conditions increase the risk for preterm birth is by increasing women's psychological distress. Our objective was to examine whether psychological distress mediated the relationship between neighborhood conditions and preterm birth. DESIGN AND SAMPLE: One hundred and one pregnant African-American women receiving prenatal care at a medical center in Chicago participated in this cross-sectional design study. MEASURES: Women completed the self-report instruments about their perceived neighborhood conditions and psychological distress between 15-26 weeks gestation. Objective measures of the neighborhood were derived using geographic information systems (GIS). Birth data were collected from medical records. RESULTS: Perceived adverse neighborhood conditions were related to psychological distress: perceived physical disorder (r = .26, p = .01), perceived social disorder (r = .21, p = .03), and perceived crime (r = .30, p = .01). Objective neighborhood conditions were not related to psychological distress. Psychological distress mediated the effects of perceived neighborhood conditions on preterm birth. CONCLUSIONS: Psychological distress in the second trimester mediated the effects of perceived, but not objective, neighborhood conditions on preterm birth. If these results are replicable in studies with larger sample sizes, intervention strategies could be implemented at the individual level to reduce psychological distress and improve women's ability to cope with adverse neighborhood conditions.


Assuntos
Negro ou Afro-Americano/psicologia , Nascimento Prematuro/etnologia , Características de Residência/estatística & dados numéricos , Estresse Psicológico/etnologia , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Chicago/epidemiologia , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Gravidez , Medição de Risco , Adulto Jovem
16.
Am J Epidemiol ; 182(6): 485-93, 2015 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-26163532

RESUMO

Perceptions of the residential environment may be associated with preterm delivery (PTD), though few studies exist. Data from the Life-course Influences on Fetal Environments (LIFE) Study (metropolitan Detroit, Michigan, 2009-2011) were used to examine whether perceptions of the current social and physical environment were associated with PTD rates among postpartum African-American women (n = 1,411). Perceptions of the following neighborhood characteristics were measured with validated multi-item scales: healthy food availability, walkability, safety, social cohesion, and social disorder. No significant associations between perceived residential environment and PTD were found in the total sample. However, education significantly modified 4 of the 5 associations (all interaction P's < 0.05). In women with ≤12 years of education, significant inverse associations were observed between PTD rates and perceptions of the following neighborhood characteristics: healthy food availability (unadjusted prevalence ratio (uPR) = 0.81, 95% confidence interval (CI): 0.68, 0.98), walkability (uPR = 0.77, 95% CI: 0.64, 0.95), and safety (uPR = 0.73, 95% CI: 0.56, 0.95). Women with ≤12 years of education also had higher PTD rates with higher social disorder (age-adjusted PR = 1.54, 95% CI: 1.10, 2.17). Null associations existed for women with >12 years of education. The PTD rates of women with lower education may be significantly affected by the physical and social residential environment.


Assuntos
Negro ou Afro-Americano , Atividades de Lazer , Atividade Motora , Nascimento Prematuro/prevenção & controle , Meio Social , Adulto , Feminino , Humanos , Recém-Nascido , Masculino , Michigan/epidemiologia , Pobreza , Nascimento Prematuro/etnologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Fatores Socioeconômicos
18.
Front Health Serv ; 4: 1349547, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38333044

RESUMO

[This corrects the article DOI: 10.3389/frhs.2023.1227874.].

19.
Placenta ; 154: 193-200, 2024 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-39032422

RESUMO

INTRODUCTION: Chronic placental inflammation is a routinely diagnosed group of placental lesions that reflect immunologic dysfunction of the mother, fetus, or both. METHODS: Complete placental pathology examinations were performed for all term births at New York Presbyterian- Brooklyn Methodist Hospital from January 2010-August 2016. Diagnoses were blinded except to gestational age. CPI lesions were marked as chronic choriodeciduitis, decidual plasma cells, chronic inflammation of basal plate with anchoring villitis, and chronic villitis. RESULTS: In this cohort of term pregnancies, 257 (11.6 %) males and 218 (9.8 %) females had ≥1 CPI lesions. Chronic villitis was the most common (319 or 14 %), with chronic choriodeciduitis, decidual plasma cells, and chronic inflammation of basal plate with anchoring villitis in 94 (4 %), 69 (3 %) and 170 (8 %), respectively. In males, chronic villitis was associated with lower gestational adjusted birthweight and had no association with placental weight. In females, chronic villitis was associated with lower gestational adjusted birthweight, but the effect became nonsignificant after adjustment for placental weight. DISCUSSION: In summary, CPI lesions' incidence and association with birth weight vary by sex. Chronic villitis is associated with lower birthweight in females; this effect is completely mediated by placental weight. Chronic villitis showed a weak direct association of chronic villitis in males, but no association with lower placental weight in males. We suggest that differences between our results and previous publications reflect effects of sampling bias.


Assuntos
Placenta , Humanos , Feminino , Gravidez , Masculino , Placenta/patologia , Adulto , Desenvolvimento Fetal/fisiologia , Doenças Placentárias/patologia , Doenças Placentárias/epidemiologia , Estudos de Coortes , Peso ao Nascer , Corioamnionite/patologia , Doença Crônica , Inflamação/patologia , Recém-Nascido
20.
Brain Behav Immun Health ; 35: 100715, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38193096

RESUMO

Background: Preterm birth rates are consistently higher in African American (AA) pregnancies compared to White pregnancies in the United States. Neighborhood racial composition, experiences of racial discrimination, and systemic inflammation are factors that have been associated with preterm birth and other adverse pregnancy outcomes that may account for these disparities. Here, we investigated whether perceived neighborhood racial composition and experiences of discrimination were predictive of cytokine levels during pregnancy among AA individuals. Methods: 545 AA individuals completed surveys and had blood samples collected at prenatal clinics in the Midwest at three timepoints (8-18,19-29, and 30-36 weeks gestation) throughout pregnancy. Pro-inflammatory [interferon (IFN)-γ, interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-α, macrophage migration inhibitory factor (MIF)] and anti-inflammatory cytokines (IL-10) were quantified. Multivariate and multilevel models were used to examine associations of perceived neighborhood racial composition and experiences of racial discrimination with cytokine levels, controlling for relevant covariates. Results: Perceived neighborhood racial composition was significantly associated with MIF at 30-36 weeks gestation in multivariate regression (p < 0.001). Living in neighborhoods with more compared to fewer White people was predictive of higher levels of MIF (b = 0.599, SE = 0.12, p < 0.001). Experiences of discrimination were also associated with higher levels of MIF (ß = 0.141, SE = 0.07, p = 0.036). Neither predictor was associated with other cytokines. Follow-up analyses revealed that neighborhood racial composition was also predictive of higher MIF levels at 8-18 weeks gestation (p = 0.02) and at 19-29 weeks gestation (p = 0.04). Conclusions: Living in neighborhoods with more White individuals and having more lifetime experiences of racial discrimination were positively related to levels of the pro-inflammatory cytokine, MIF, among pregnant AA individuals. MIF's known positive relationships with chronic stress and preterm birth suggest that these elevations in MIF may have negative health consequences. Future studies should explore whether MIF serves as a pathway between neighborhood racial composition or experiences of racial discrimination and preterm birth risk among AA individuals.

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