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. 2021 Apr;8(2):519-531.
doi: 10.1007/s40615-020-00809-4. Epub 2020 Jul 1.

Hair Cortisol Concentration and Perceived Chronic Stress in Low-Income Urban Pregnant and Postpartum Black Women

Keaton Somerville  1 , Angela Neal-Barnett  2 , Robert Stadulis  2 , Laura Manns-James  3 , Diane Stevens-Robinson  2
Affiliations

Hair Cortisol Concentration and Perceived Chronic Stress in Low-Income Urban Pregnant and Postpartum Black Women

Keaton Somerville et al. J Racial Ethn Health Disparities. 2021 Apr.

Abstract

Black women are more likely to experience short- or long-term health consequences from their labor and delivery and die from pregnancy-related causes than White women. Similarly, infants born to Black women also have heightened health risks. Developing research suggests that a contributing factor to Black health disparities may be maternal chronic stress. A widely used biomarker for chronic stress is hair cortisol concentration (HCC). Few prior studies have explored the HCC of pregnant Black women or comprehensively examined perceived chronic stress in this population. Using a mixed-methods focus group framework, we assessed HCC and perceived chronic stress among low-income pregnant and postpartum Black women. Four focus groups were conducted (N = 24). The mean HCC for our pregnant Black participants was greater than pregnant White women in reviewed published studies. The high levels of stress evidenced at all pregnancy stages indicate that many of these women are experiencing chronic stress, which can contribute to higher Black maternal morbidity and mortality rates, and possibly infant mortality rates. From the open coding of the focus group transcripts, 4 themes emerged: chronic stress, experiences of racism, experiences of trauma, and negative thinking. Selective coding based on these themes revealed cumulative experiences of chronic stress, various traumatic experiences, and frequent encounters with racism. Negative thinking styles were observed across the 4 focus groups. More studies of HCC and perceived stress among pregnant Black women are encouraged. Findings suggest the need for tailored multi-level interventions given the layers of stressors present in this population.

Keywords: Black; Chronic stress; Hair cortisol; Infant; Mortality; Women.

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References

    1. Vilda D, Wallace M, Dyer L, Harville E, Theall K. Income inequality and racial disparities in pregnancy-related mortality in the US. SSM Popul Health. 2019;9:100477. Published 2019 Aug 28. https://doi.org/10.1016/j.ssmph.2019.100477 . - DOI - PubMed - PMC
    1. Koblinsky M, Chowdhury ME, Moran A, Ronsmans C. Maternal morbidity and disability and their consequences: neglected agenda in maternal health. J Health Popul Nutr. 2012;30(2):124–30. https://doi.org/10.3329/jhpn.v30i2.11294 . - DOI - PubMed - PMC
    1. Howell EA. Reducing disparities in severe maternal morbidity and mortality. Clin Obstet Gynecol. 2018;61(2):387–99. https://doi.org/10.1097/GRF.0000000000000349 . - DOI - PubMed - PMC
    1. Ely DM, Driscoll AK. Infant mortality in the United States, 2017: data from the period linked birth/infant death file. Natl Vital Stat Rep. 2019;68(10):1–20. - PubMed
    1. Kothari CL, Paul R, Dormitorio B, et al. The interplay of race, socioeconomic status and neighborhood residence upon birth outcomes in a high black infant mortality community. SSM Popul Health. 2016;2:859–67. Published 2016 Oct 1. https://doi.org/10.1016/j.ssmph.2016.09.011 . - DOI - PubMed - PMC

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