The Association between Maternal Experiences of Interpersonal Discrimination and Adverse Birth Outcomes: A Systematic Review of the Evidence

Abstract

In the present systematic review, we argue that maternal experiences of interpersonal discrimination at least partially account for the disproportionate rates of adverse birth outcomes in minority populations. Since the 1990s, research in this area has slowly, but steadily increased, shedding more light on the insidious nature of interpersonal discrimination and its toxic health effects. With the aim of bringing this topic to the fore in academic as well as clinical settings, this paper provides a state-of-the-art review of the empirical knowledge on the relationship between maternal experiences of discrimination and birth outcomes. Of 5901 articles retained in the literature search, 28 met the predefined inclusion criteria. Accounting for a range of health and behavioral factors, the vast majority of these studies support the notion that maternal experiences of interpersonal discrimination predict a range of adverse birth outcomes, including preterm birth, low birth weight, and various physiological markers of stress (allostatic load) in both mother and child pre- and postpartum. Several moderators and mediators of this relationship were also identified. These related primarily to the type (first-hand and vicarious), timing (childhood, adolescence, and adulthood), frequency, and pervasiveness of discrimination experienced, as well as to maternal mental health and coping. More research into these factors, however, is required to definitively determine their significance. We discuss these findings as they relate to the general health repercussions of interpersonal discrimination, as well as in terms of applied prenatal care and interventions. Ultimately, we argue that assessing maternal experiences of interpersonal discrimination in prenatal care may represent a considerable asset for mitigating existing majority-minority disparities in adverse birth outcomes.

Which roads lead to depression in Latinas? A network analysis of prenatal depressive symptoms, discrimination, acculturative stress, and low birth weight

“…Lifetime experiences of discrimination, including witnessing a caregiver discriminated against, have been linked to having an infant with LBW (Larrabee Sonderlund et al, 2021). Although LBWs were more closely tied to growing up in the United States as a young child than with prenatal discrimination, the discrimination node indirectly enabled the connection between greater acculturation and LBW.…”

“…This cycle may begin in early childhood, whereby early psychosocial stress may become biologically embedded through epigenetic mechanisms (Miller et al, 2011). The resulting pro‐inflammatory state may underlie multiple stress‐related health conditions, including depressive symptomology and obstetric complications during the child‐bearing years (Larrabee Sonderlund et al, 2021). In this way, childhood exposures as women arrive and acculturate to the United States may increase not only biological vulnerability to depressive symptoms but vulnerability to having an infant with LBW.…”

The contribution of racism-related stress and adversity to disparities in birth outcomes: evidence and research recommendations

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