title: Lifetime racism and blood pressure changes during pregnancy: implications for fetal growth.
abstract: OBJECTIVE
  Research suggests that exposure to racism partially explains why African American women are 2 to 3 times more likely to deliver low birth weight and preterm infants. However, the physiological pathways by which racism exerts these effects are unclear. This study examined how lifetime exposure to racism, in combination with maternal blood pressure changes during pregnancy, was associated with fetal growth.
  
  
  METHODS
  African American pregnant women (n = 39) reported exposure to childhood and adulthood racism in several life domains (e.g., at school, at work), which were experienced directly or indirectly, meaning vicariously experienced when someone close to them was treated unfairly. A research nurse measured maternal blood pressure at 18 to 20 and 30 to 32 weeks gestation. Standardized questionnaires and trained interviewers assessed maternal demographics. Neonatal length of gestation and birth weight data were collected from medical charts.
  
  
  RESULTS
  Childhood racism interacted with diastolic blood pressure to predict birth weight. Specifically, women with two or more domains of indirect exposure to racism in childhood and increases in diastolic blood pressure between 18 and 32 weeks had lower gestational age adjusted birth weight than the other women. A similar pattern was found for direct exposure to racism in childhood.
  
  
  CONCLUSIONS
  Increases in diastolic blood pressure between the second and third trimesters predicted lower birth weight, but only when racism exposure in childhood (direct or indirect) was relatively high. Understanding pregnant African American women's lifetime direct and indirect experiences with racism in combination with prenatal blood pressure may improve identification of highest risk subgroups within this population.
authors: Department of Psychology.
authors: Clayton J
authors: CJ
authors: Hilmert
authors: School of Social Work.
authors: Tyan Parker
authors: TP
authors: Dominguez
authors: Department of Psychology.
authors: Christine Dunkel
authors: CD
authors: Schetter
authors: Department of Obstetrics and Gynecology.
authors: Sindhu K
authors: SK
authors: Srinivas
authors: Crean School of Health and Life Sciences.
authors: Laura M
authors: LM
authors: Glynn
authors: Department of Obstetrics, Gynecology and Pediatrics.
authors: Calvin J
authors: CJ
authors: Hobel
authors: Department of Psychiatry and Human Behavior.
authors: Curt A
authors: CA
authors: Sandman
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D001724:Birth Weight / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D005865:Gestational Age; D054624:Health Status Disparities; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D036301:Qualitative Research; D063505:Racism / Q000208:ethnology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
references: Psychol Sci. 2012 Jan 1;23(1):93-100
references: 22173740
references: Psychosom Med. 2005 Jul-Aug;67(4):625-31
references: 16046378
references: BMJ. 2001 Aug 11;323(7308):310-4
references: 11498487
references: Paediatr Perinat Epidemiol. 2007 Jul;21(4):310-8
references: 17564587
references: Sleep. 2009 Aug;32(8):1086-92
references: 19725260
references: BMJ. 1990 Nov 17;301(6761):1111
references: 2252919
references: Soc Sci Med. 2006 Sep;63(6):1415-27
references: 16750286
references: Paediatr Perinat Epidemiol. 2000 Apr;14(2):127-35
references: 10791655
references: Am J Obstet Gynecol. 1991 Oct;165(4 Pt 1):902-6
references: 1951551
references: Paediatr Perinat Epidemiol. 2009 May;23(3):254-63
references: 19775387
references: Psychol Bull. 2005 Sep;131(5):662-83
references: 16187853
references: Soc Sci Med. 2009 Jul;69(2):258-65
references: 19386406
references: Soc Sci Med. 2011 Mar;72(6):977-83
references: 21345565
references: J Pediatr Psychol. 2007 Nov-Dec;32(10):1238-48
references: 17569710
references: Ann Behav Med. 2000 Summer;22(3):214-22
references: 11126466
references: N Engl J Med. 1991 Nov 28;325(22):1551-6
references: 1944439
references: Am J Physiol. 1998 May;274(5):H1605-12
references: 9612370
references: Lancet. 1997 Jan 4;349(9044):7-10
references: 8988114
references: Psychol Bull. 2011 Nov;137(6):959-97
references: 21787044
references: Eur J Epidemiol. 2011 Jul;26(7):571-81
references: 21681547
references: J Clin Endocrinol Metab. 2007 Nov;92(11):4094-100
references: 17848405
references: Psychosom Med. 2008 Jan;70(1):57-64
references: 18158373
references: Eur J Obstet Gynecol Reprod Biol. 2004 Sep 10;116(1):3-15
references: 15294360
references: Am J Obstet Gynecol. 1985 May 15;152(2):155-63
references: 3890544
references: Ethn Dis. 1991 Spring;1(2):154-70
references: 1842532
references: Health Psychol. 2010 Jul;29(4):394-402
references: 20658827
references: Ann N Y Acad Sci. 2004 Dec;1032:63-84
references: 15677396
references: Ethn Health. 2010 Apr;15(2):121-43
references: 20131130
references: Psychosom Med. 2007 Jun;69(5):402-9
references: 17556642
references: Ann Behav Med. 2003 Winter;25(1):55-65
references: 12581937
references: Am J Public Health. 2004 Dec;94(12):2125-31
references: 15569964
references: Am J Public Health. 2004 Dec;94(12):2132-8
references: 15569965
references: Am J Obstet Gynecol. 2011 May;204(5):431.e1-8
references: 21419384
references: Clin Obstet Gynecol. 2008 Jun;51(2):360-70
references: 18463466
references: Epidemiology. 2000 May;11(3):337-9
references: 10784254
references: Am Psychol. 1999 Oct;54(10):805-16
references: 10540593
references: Psychosom Med. 2003 Jan-Feb;65(1):46-62
references: 12554815
references: Biol Psychiatry. 1996 Sep 1;40(5):389-97
references: 8874840
references: Br J Obstet Gynaecol. 1985 Jan;92(1):39-45
references: 3966989
references: J Behav Med. 2009 Feb;32(1):20-47
references: 19030981
references: Ann N Y Acad Sci. 1998 May 1;840:33-44
references: 9629234
references: Am J Obstet Gynecol. 2005 May;192(5 Suppl):S47-55
references: 15891712
references: BMJ. 1997 Aug 16;315(7105):401-3
references: 9277604
references: Br J Obstet Gynaecol. 1986 Oct;93(10):1049-59
references: 3790464
references: Ann Behav Med. 2005 Feb;29(1):12-21
references: 15677296
references: Clin Sci. 1969 Oct;37(2):395-407
references: 5358998
references: J Child Psychol Psychiatry. 2011 Feb;52(2):119-29
references: 20854366
references: Placenta. 2009 Jul;30(7):619-24
references: 19464055
references: Obstet Gynecol. 2001 Sep;98(3):427-33
references: 11530124
references: Health Psychol. 2008 Mar;27(2):194-203
references: 18377138
references: Soc Sci Med. 2005 Oct;61(7):1576-96
references: 16005789
references: Am J Public Health. 2007 Jul;97(7):1191-7
references: 17538073
references: J Natl Med Assoc. 2004 Feb;96(2):187-95
references: 14977277
references: J Natl Med Assoc. 2005 Nov;97(11):1516-26
references: 16334498
references: Am J Obstet Gynecol. 2005 May;192(5 Suppl):S30-5
references: 15891710
references: Psychoneuroendocrinology. 2010 Jan;35(1):141-53
references: 19674845
references: Am J Prev Med. 1993 Nov-Dec;9(6 Suppl):82-122
references: 8123288
references: Am J Obstet Gynecol. 1996 Nov;175(5):1317-24
references: 8942508
references: Am J Obstet Gynecol. 1996 Dec;175(6):1534-42
references: 8987938
references: Matern Child Health J. 2009 Jan;13(1):29-39
references: 18463971
references: J Pers. 2004 Dec;72(6):1365-93
references: 15509286