title: Perceived discrimination and depressive symptoms, smoking, and recent alcohol use in pregnancy.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Ian M
authors.initials: IM
authors.lastname: Bennett
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: Culhane
authors.forename: David A
authors.initials: DA
authors.lastname: Webb
authors.forename: James C
authors.initials: JC
authors.lastname: Coyne
authors.forename: Vijaya
authors.initials: V
authors.lastname: Hogan
authors.forename: Leny
authors.initials: L
authors.lastname: Mathew
authors.forename: Irma T
authors.initials: IT
authors.lastname: Elo
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D004192:Discrimination, Psychological; D005260:Female; D006801:Humans; D011203:Poverty; D011247:Pregnancy; D012907:Smoking / Q000523:psychology*