Stress, Race, and Pregnancy: A Health Disparity

In Arizona black women have a preterm birth rate of 40% higher than any other women. Black women in Maricopa County have the highest incidence of low birthweight and preterm birth. Preterm birth has been linked to cerebral palsy, blindness, cognitive difficulties, and ultimately, infant mortality. Preterm birth is defined by the World Health Organization as delivery of an infant before 37 weeks of gestation. Low birth weight is defined as 1500g or less with extremely low birthweight being 1000g or less. Infants with low birth weight contribute disproportionately to infant mortality. Chronic, toxic stress is a heavy contributor to the racial health disparity of preterm birth and low birth weight. Chronic stress may affect preterm birth by dysregulating the hypothalamic-pituitary-adrenal axis, altering the release of cortisol, leading to altered immune function, thus increasing infection and inflammation response (Giuregescu et. al). Studies have shown racial injustice is related to inflammatory stress response. This stress is exacerbated by the long history of injustice and neglect in healthcare due to implicit bias. Recommendations for improvement of this disparity includes cultural competency training for all healthcare professionals and mindfulness yoga training paired with Focused Support Groups for pregnant women for reducing racial stress.