Date of Award

January 2014

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Trace Kershaw

Abstract

We examined the association between life events stressors during pregnancy and low birth weight (LBW) among African Americans and Whites, while systematically controlling for potential confounders including individual characteristics and city-level variations and clustering. Data from 4970 women with singleton births from the 2007 and 2010 Los Angeles Mommy and Baby Surveys were analyzed. Multilevel logistic regression was used to assess the association between emotional, financial, spousal and traumatic stressors and LBW among African Americans and Whites. Potential confounders included were: city-level Economic Hardship Index, maternal demographics, pre-pregnancy conditions, insurance, behavioral risk factors and social support. African Americans were significantly more likely to experience any domain of stressors during their pregnancy, compared to Whites (p<0.001). Only the association between financial stressors and LBW was significantly different between African Americans and Whites (P for interaction=0.015). Experience of financial stressors during pregnancy was significantly associated with LBW among African Americans (adjusted Odds Ratio=1.49; 95% Confident Interval=1.01, 2.22) but not Whites. Differential impact of financial stressors during pregnancy may contribute to racial disparities in LBW among African Americans and Whites. We showed financial life event stressors, but not other domains of stressors, were more likely to impact African Americans than Whites. Financial stress during pregnancy is an important area for public health to address in order to improve birth outcomes among African Americans.

Comments

This is an Open Access Thesis.

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