Maternal Experiences with Everyday Discrimination and Infant Birth Weight: A Test of Mediators and Moderators Among Youn
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ORIGINAL ARTICLE
Maternal Experiences with Everyday Discrimination and Infant Birth Weight: A Test of Mediators and Moderators Among Young, Urban Women of Color Valerie A. Earnshaw, Ph.D. & Lisa Rosenthal, Ph.D. & Jessica B. Lewis, LMFT & Emily C. Stasko, MPH & Jonathan N. Tobin, Ph.D. & Tené T. Lewis, Ph.D. & Allecia E. Reid, Ph.D. & Jeannette R. Ickovics, Ph.D. Published online: 28 August 2012 # The Society of Behavioral Medicine 2012
Abstract Background Racial/ethnic disparities in birth weight persist within the USA. Purpose The purpose of this study is to examine the association between maternal everyday discrimination and infant birth weight among young, urban women of color as well as mediators (depressive symptoms, pregnancy distress, and pregnancy symptoms) and moderators (age, race/ethnicity, and attributions of discrimination) of this association. Methods A total of 420 women participated (14–21 years old; 62 % Latina, 38 % Black), completing measures of everyday discrimination and moderators during their second trimester of pregnancy and mediators during their third trimester. Birth weight was primarily recorded from medical record review. Results Path analysis demonstrated that everyday discrimination was associated with lower birth weight. Depressive symptoms mediated this relationship, and no tested factors moderated this relationship. Conclusions Given the association between birth weight and health across the lifespan, it is critical to reduce discrimination directed at young, urban women of color so that all children can begin life with greater promise for health. V. A. Earnshaw (*) : L. Rosenthal : J. B. Lewis : E. C. Stasko : T. T. Lewis : A. E. Reid : J. R. Ickovics Yale School of Public Health and the Yale Center for Interdisciplinary Research on AIDS, 135 College Street, Suite 200, New Haven, CT 06510, USA e-mail: [email protected] V. A. Earnshaw e-mail: [email protected] J. N. Tobin Clinical Directors’ Network, New York, NY, USA
Keywords Everyday discrimination . Birth weight . Depressive symptoms . Pregnancy distress . Adolescents . Pregnancy
Introduction Racial/ethnic disparities in birth weight within the USA are pronounced. In 2009, the rate of low birth weight infants (i.e., less than 2,500 g or 5 lb, 8 oz) was 5.23 % for White women, 5.72 % for Latina women, and 11.44 % for Black women [1]. Although rates of low birth weight are generally similar between White and Latina women (e.g., Mexican), certain Latina women (e.g., Puerto Rican) are more likely to give birth to low birth weight infants [2]. Birth weight, in turn, is associated with health across the lifespan. Low birth weight is among the three leading causes of infant death [3] and is further associated with intubation at birth, sepsis, and seizures during the first day of life [4]. Low birth weight infants are more likely to suffer chronic lung disease [5] and be hospitalized during the first year of life [6]. By childhood, low birth weight is associated with greater illness and neurodevelopmental problems [7
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