title: Racial/ethnic differences in self-reported and biologic measures of chronic stress in pregnancy.
abstract: OBJECTIVE
  Racial differences in chronic maternal stress may contribute to disparities in pregnancy outcomes. The objective is to identify racial and ethnic differences in self-reported and biologic measures of stress between non-Hispanic black (NHB) and non-Hispanic white (NHW) pregnant women.
  
  
  METHODS
  NHB and NHW pregnant women were enrolled before 23 weeks of gestation in this prospective cohort study. Equal numbers of women were recruited with public vs private insurance in each racial group. Self-reported stress was measured and blood samples collected in the second and third trimesters were analyzed for serum Epstein-Barr virus antibody, C-reactive protein (CRP), corticotropin-releasing hormone (CRH) and adenocorticotropic hormone (ACTH).
  
  
  RESULTS
  One hundred and twelve women were enrolled. NHW women reported more buffers against stress (P=0.04) and neighborhood satisfaction (P=0.02). NHB women reported more discrimination (P<0.001), food insecurity (P=0.04) and had significantly higher mean CRP levels and mean ACTH levels in the second and third trimesters.
  
  
  CONCLUSIONS
  Significant differences in self-reported and biologic measures of chronic stress were identified between NHB and NHW pregnant women with similar economic characteristics. Future studies should investigate mechanisms underlying these differences and their relationship to pregnancy outcomes.
authors: 1] Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, IL, USA [2] Department of Obstetrics and Gynecology, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA [3] Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA [4] Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors: A E B
authors: AE
authors: Borders
authors: Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors: K
authors: K
authors: Wolfe
authors: Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, IL, USA.
authors: S
authors: S
authors: Qadir
authors: Department of Preventative Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors: K-Y
authors: KY
authors: Kim
authors: 1] Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL, USA [2] Department of Preventative Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA [3] Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors: J
authors: J
authors: Holl
authors: 1] Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL, USA [2] Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors: W
authors: W
authors: Grobman
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D001741:Black or African American / Q000208:ethnology; D000914:Antibodies, Viral / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D003346:Corticotropin-Releasing Hormone / Q000097:blood; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications; D011262:Pregnancy Trimester, Second / Q000097:blood*; D011263:Pregnancy Trimester, Third / Q000097:blood*; D037841:Pregnant People / Q000523:psychology*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000175:diagnosis / Q000208:ethnology*; D014481:United States / Q000208:ethnology; D044465:White People
chemical_list: D000914:Antibodies, Viral; D015415:Biomarkers; D000324:Adrenocorticotropic Hormone; D002097:C-Reactive Protein; D003346:Corticotropin-Releasing Hormone