Racial/Ethnic Differences in Self-Reported and Biologic Measures of Chronic Stress in Pregnancy

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. STUDY DESIGN: NHB and NHW pregnant women were enrolled prior to 23 weeks gestation in this prospective cohort study. Equal numbers of women were recruited with public versus private insurance in each racial group. Self-reported stress was measured and blood samples collected in the 2(nd) and 3(rd) trimesters were analyzed for serum Epstein - Barr virus (EBV) antibody, C - reactive protein (CRP), corticotropin-releasing hormone (CRH), and adenocorticotropic hormone (ACTH). RESULTS: 112 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 2(nd) and 3(rd) trimesters. CONCLUSION: 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.