Segre Lisa S, Mehner Brooke T, Brock Rebecca L
College of Nursing, University of Iowa, Iowa City, Iowa.
Iowa Department of Public Health, Des Moines, Iowa.
Womens Health Issues. 2021 May-Jun;31(3):254-262. doi: 10.1016/j.whi.2020.12.008. Epub 2021 Feb 23.
The negative impact of stress on the mental health of perinatal women is well-established. Prior research using data from the Pregnancy Risk Assessment Monitoring System (PRAMS) confirms three distinct stress domains: financial, relationship, and trauma. In 2013, an item assessing perceived racial discrimination was added to the Iowa PRAMS. Using the first phase of available data, we examine whether perceived racial discrimination represents an independent stress domain and assess its association with postpartum depressed mood.
A principal component analysis of the Iowa PRAMS data (2013-2015: N = 2,805) evaluated stress and perceived racial discrimination. Logistic regression examined the effect of racial discrimination on postpartum depressed mood.
In Iowa, 4.4% of respondents perceived racial discrimination, with higher rates among non-Hispanic Black women and Hispanic women. The principal component analysis identified five stress domains: financial, relational, traumatic, emotional, and displacement. Perceived racial discrimination did not load onto any of these domains, suggesting that it represents an independent stress component. Logistic regression indicated that those who experienced perceived racial discrimination were twice as likely to have experienced depressed mood.
Racism, in the form of perceived racial discrimination among pregnant women, is a unique domain of stress that is significantly associated with an increased risk for depressed postpartum mood. Decreasing discrimination's effects on perinatal mental health could begin with ensuring respectful and compassionate health care during pregnancy and the postpartum period.
压力对围产期女性心理健康的负面影响已得到充分证实。先前使用妊娠风险评估监测系统（PRAMS）数据的研究确认了三个不同的压力领域：经济、人际关系和创伤。2013年，爱荷华州PRAMS增加了一项评估感知到的种族歧视的项目。利用现有数据的第一阶段，我们研究感知到的种族歧视是否代表一个独立的压力领域，并评估其与产后抑郁情绪的关联。
对爱荷华州PRAMS数据（2013 - 2015年：N = 2805）进行主成分分析，以评估压力和感知到的种族歧视。逻辑回归分析种族歧视对产后抑郁情绪的影响。
在爱荷华州，4.4%的受访者感知到种族歧视，非西班牙裔黑人女性和西班牙裔女性的比例更高。主成分分析确定了五个压力领域：经济、人际关系、创伤、情绪和流离失所。感知到的种族歧视并未归入这些领域中的任何一个，这表明它代表一个独立的压力成分。逻辑回归表明，经历过感知到的种族歧视的人出现抑郁情绪的可能性是其他人的两倍。
以孕妇感知到的种族歧视为形式的种族主义是一个独特的压力领域，与产后抑郁情绪风险增加显著相关。减少歧视对围产期心理健康的影响可以从确保孕期和产后提供尊重和富有同情心的医疗保健开始。
