Racial Discrimination and Stress Across the Life Course: Associations With Prenatal Inflammation, Perceived Stress, and Depressive Symptoms.

This was a secondary analysis of a cohort whose parent study was powered for other aims, with 93 women in the analytical sample. The sample was restricted to non-Hispanic Black U.S.-born women aged 18 to 34 who were non-smoking, reported no illicit drug use, had pre-pregnancy BMI 18.5 to 39.9, and did not report certain immune conditions, immune-impacting medications, or pregnancy complications at screening. Many participants were recruited from sites serving under- or uninsured patients, so the results may not apply broadly. Discrimination, life-course stress, perceived stress, depressive symptoms, and cytokines were measured at one early third-trimester visit, so the study cannot show timing or causation. The analysis tested many outcomes and interactions, and some cytokine and perceived-stress findings depended on stress ratings being below or above percentiles. Some women retained in the sample were later found to have chronic hypertension or gestational hypertensive disorders, and social support or systemic racism were not measured.

The authors declared no conflicts of interest. The article is listed as supported by NIH extramural and non-U.S. government research support.

Do not conclude that racial discrimination causes higher inflammation or depression, or that asking about discrimination will improve birth outcomes. This was an observational secondary analysis of 93 women with no treatment tested, and many associations depended on stress ratings or were not significant.