Research issues in the study of very low birthweight and preterm delivery among African-American women.

Very low birthweight and preterm delivery explain two thirds of the excess deaths experienced by African-American infants. Although comprehensive, good quality services for all African-American women will help to reduce the twofold higher rate of infant mortality experienced by African-American infants compared with white infants, the infant mortality gap will not be closed until prevention research is conducted that incorporates the social, cultural, and political context of life for African-American women; the environmental stressors and the physiologic responses associated with stress; and the protective mechanisms available in the community for responding to stress. Discrimination may be an important stressor that influences a woman's susceptibility to a poor pregnancy outcome. Strategies already exist in the community to cope with discrimination and other environmental stressors. To capture the effects of discrimination and other environmental factors and the protective factors important for prevention, the research approach must involve African-American women and their communities as collaborators in the research. Such collaboration will help to avoid problems with scientific racism.