Barriers to health care and pregnancy experiences in relation to Black, low-income mothers' perinatal attachment and depression.

The goal of this study was to examine whether barriers to accessing health care and negative pregnancy experiences would predict depressive symptomatology and attachment to their neonates among Black mothers from low-income backgrounds across the perinatal period. We were also interested in examining whether these mothers' engagement in prenatal health practices would buffer against their pregnancy experiences to promote positive postnatal maternal functioning. Participants were 118 Black pregnant women from low-income backgrounds, recruited from WIC and Early Head Start programs. A prenatal assessment between 28 and 40 weeks gestation measured pregnancy experiences and prenatal health practices, and a postnatal assessment about 4 weeks postpartum measured maternal functioning in the form of depressive symptoms and attachment to their neonates. Linear regressions with prenatal health practices included as a moderator suggested that while engaging in positive health practices during pregnancy could potentially buffer against negative pregnancy experiences and prenatal depressive symptoms, it is unlikely to buffer against barriers to accessing health care. These results imply the need to provide support for accessing health care among pregnant women to address disparities in the United States. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Impact of Neighborhood Socioeconomic Status, Race and Ethnicity, and Language on Prenatal Diagnosis of CHD.

Congenital heart disease (CHD) is the most prevalent birth defect. This study aimed to assess whether prenatal diagnosis (PD) of CHD and time of the diagnosis are associated with maternal race, ethnicity, neighborhood SES, and language. In this retrospective cohort study, we analyzed data on 163 patients who underwent surgical intervention for CHD within 30 days of birth between 2011 and 2020 at the University of Maryland Children's Hospital. A neighborhood SES score was calculated using the mother's address at time of discharge and 6 SES variables from the US Census block group data with a previously published method by Diez Roux et al. Neighborhood SES did not impact the likelihood of receiving a PD of CHD; however, patients of Latino ethnicity were 3.2 times and non-English-preferred language patients were 5.1 times more likely to not receive a PD. Patients whose preferred language was a non-English language received a prenatal diagnosis 5.3 weeks later, resulting in the PD being made in the third trimester rather than the second. Patients from the highest quartile SES received an earlier prenatal diagnosis, although this association was less significant when controlling for insurance type and preferred language. Significant disparities in PD of CHD were seen in patients of Latino ethnicity and patients who prefer non-English language. Better understanding of the root causes of these disparities will be important to guide interventions to reduce these disparities.