Scroggins Jihye Kim, Topaz Maxim, Min Se Hee, Barcelona Veronica
J Obstet Gynecol Neonatal Nurs. 2025 Jan;54(1):60-87. doi: 10.1016/j.jogn.2024.07.004. Epub 2024 Aug 25.
To identify lifetime discrimination typologies and examine their associations with psychological health outcomes among Black and Hispanic women after birth.
Secondary analysis of the Community and Child Health Network study data.
A total of 1,350 Black and 607 Hispanic women.
We built two latent class models for Black and Hispanic women using eight indicator variables from different life domains of discrimination (childhood, family, work, police, education, housing, health care, and loans). We used bivariate and multiple regression analyses to examine the association among the identified typologies and postpartum depression and perceived stress at 6 months postpartum.
We selected the three-class model with best fit indices and interpretability: no lifetime discrimination (n = 1,029; 76.22%), high childhood-family racial discrimination (n = 224, 16.59%), and moderate lifetime discrimination (n = 97, 7.19%) among Black women and no lifetime discrimination (n = 493, 81.22%), high childhood-family racial discrimination (n = 93, 15.32%), and high education discrimination (n = 21, 3.46%) among Hispanic women. The adjusted postpartum depression and perceived stress scores were significantly greater in Typologies 2 and 3 than Typology 1 in Black women. The adjusted perceived stress scores were significantly greater in Typologies 2 and 3 than Typology 1 in Hispanic women.
Lifetime discrimination experiences manifested in complex patterns. Women who experienced moderate to high discrimination across all or specific life domains had worse postpartum depression and perceived stress at 6 months after birth. It is crucial to address lifetime discrimination to improve maternal mental health.
识别终生歧视类型,并研究其与黑人及西班牙裔女性产后心理健康结果之间的关联。
对社区与儿童健康网络研究数据进行二次分析。
共有1350名黑人女性和607名西班牙裔女性。
我们使用来自不同歧视生活领域(童年、家庭、工作、警察、教育、住房、医疗保健和贷款)的八个指标变量,为黑人和西班牙裔女性构建了两个潜在类别模型。我们使用双变量和多元回归分析来检验所识别的类型与产后抑郁症以及产后6个月时感知到的压力之间的关联。
我们选择了拟合指数和可解释性最佳的三类模型:黑人女性中无终生歧视(n = 1029;76.22%)、童年 - 家庭种族歧视程度高(n = 224,16.59%)和终生歧视程度中等(n = 97,7.19%),以及西班牙裔女性中无终生歧视(n = 493,81.22%)、童年 - 家庭种族歧视程度高(n = 93,15.32%)和教育歧视程度高(n = 21,3.46%)。在黑人女性中,第2类和第3类的调整后产后抑郁和感知压力得分显著高于第1类。在西班牙裔女性中,第2类和第3类的调整后感知压力得分显著高于第1类。
终生歧视经历呈现出复杂的模式。在所有或特定生活领域经历中度至高度歧视的女性,产后6个月时的产后抑郁和感知压力更严重。解决终生歧视对于改善孕产妇心理健康至关重要。