title: Association Between Life Event Stressors and Low Birth Weight in African American and White Populations: Findings from the 2007 and 2010 Los Angeles Mommy and Baby (LAMB) Surveys.
abstract: We examined the association between life events stressors during pregnancy and low birth weight (LBW) among African Americans and Whites, while systematically controlling for potential confounders including individual characteristics and city-level variations and clustering. We analyzed data from 4970 women with singleton births who participated in the 2007 and 2010 Los Angeles Mommy and Baby Surveys. Multilevel logistic regression was used to assess the association between emotional, financial, spousal and traumatic stressors and LBW among African Americans and Whites. Potential confounders included were: the city-level Economic Hardship Index, maternal demographics, pre-pregnancy conditions, insurance, behavioral risk factors and social support. African Americans were significantly more likely to experience any domain of stressors during their pregnancy, compared to Whites (p < 0.001). Only the association between financial stressors and LBW was significantly different between African Americans and Whites (p for interaction = 0.015). Experience of financial stressors during pregnancy was significantly associated with LBW among African Americans (adjusted odds ratio = 1.49; 95 % confidence interval = 1.01-2.22) but not Whites. Differential impact of financial stressors during pregnancy may contribute to racial disparities in LBW between African Americans and Whites. We showed that financial life event stressors, but not other domains of stressors, were more likely to impact LBW among African Americans than Whites. Initiatives aimed at mitigating the negative impacts of financial stress during pregnancy may contribute to reducing disparities in birth outcomes between African Americans and Whites.
authors: Yale School of Public Health, New Haven, CT, USA. yuan.zhao@aya.yale.edu.|Los Angeles County Department of Public Health, Maternal, Child and Adolescent Health Programs, Los Angeles, CA, USA. yuan.zhao@aya.yale.edu.
authors: Yuan
authors: Y
authors: Zhao
authors: Yale School of Public Health, New Haven, CT, USA. trace.kershaw@yale.edu.|Yale Center for Interdisciplinary Research on AIDS, New Haven, CT, USA. trace.kershaw@yale.edu.
authors: Trace
authors: T
authors: Kershaw
authors: Yale School of Public Health, New Haven, CT, USA. Adrienne.ettinger@yale.edu.|Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, New Haven, CT, USA. Adrienne.ettinger@yale.edu.
authors: Adrienne S
authors: AS
authors: Ettinger
authors: Los Angeles County Department of Public Health, Maternal, Child and Adolescent Health Programs, Los Angeles, CA, USA. chiggins@ph.lacounty.gov.
authors: Chandra
authors: C
authors: Higgins
authors: Health Resources and Services Administration, U.S. Department of Health and Human Services, Rockville, MD, USA. Michael.Lu@hrsa.hhs.gov.
authors: Michael C
authors: MC
authors: Lu
authors: Los Angeles County Department of Public Health, Maternal, Child and Adolescent Health Programs, Los Angeles, CA, USA. schao@ph.lacounty.gov.
authors: Shin M
authors: SM
authors: Chao
mesh_terms: D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D008016:Life Change Events; D015141:Los Angeles / Q000453:epidemiology; D055361:Multilevel Analysis; D011247:Pregnancy; D011248:Pregnancy Complications; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications* / Q000453:epidemiology; D011795:Surveys and Questionnaires; D044465:White People / Q000523:psychology* / Q000706:statistics & numerical data
keywords: Financial stress; Life event stressor; Low birth weight; Multilevel analysis; Racial disparity