Prenatal Cigarette Smoking As a Mediator Between Racism and Depressive Symptoms: The Biosocial Impact on Black Births Study

Overview

Journal Public Health Nurs

Date 2020 Aug 1

PMID 32734603

Citations 5

Authors

Carmen Giurgescu

Liying Zhang

Mercedes A Price

Rhonda K Dailey

Heather A Frey

Deborah S Walker

Shannon N Zenk

Christopher G Engeland

Cindy M Anderson

Dawn P Misra

Affiliations

Soon will be listed here.

Abstract

Objective: This study examined whether cigarette smoking mediated the association of racial discrimination with depressive symptoms among pregnant Black women.

Design: Cross-sectional.

Sample: Two hundred Black women at 8-29 weeks gestation.

Measurements: Women completed questionnaires including the Experiences of Discrimination and the Center for Epidemiologic Studies-Depression (CES-D) scales, as well as questions about sociodemographic characteristics and cigarette smoking.

Results: The mean age of the sample was 26.9 ± 5.7 years and the mean gestational age at data collection was 15.6 ± 5.7 weeks. Approximately 17% of women reported prenatal cigarette smoking; 27% had prenatal CES-D scores ≥23, which have been correlated with depression diagnoses; and 59% reported ever (lifetime) experiencing discrimination in at least one situation (e.g., at work). Path analysis results indicated that the standardized indirect effect of experiences of racial discrimination on CES-D scores through prenatal smoking was statistically significant (standardized indirect effect = 0.03; 95% CI: 0.001, 0.094; p = .042).

Conclusion: Cigarette smoking during pregnancy partially mediated the association between lifetime experiences of racial discrimination and prenatal depressive symptoms among pregnant Black women. Smoking cessation programs should focus on identifying and treating depressive symptoms among pregnant Black women.

Citing Articles

Investigating the Role of Race and Stressful Life Events on the Smoking Patterns of Pregnant and Postpartum Women in the United States: A Multistate Pregnancy Risk Assessment Monitoring System Phase 8 (2016-2018) Analysis.

Yakubu R, Ajayi K, Dhaurali S, Carvalho K, Kheyfets A, Lawrence B Matern Child Health J. 2023; 27(Suppl 1):166-176.

PMID: 37737325 PMC: 10692264. DOI: 10.1007/s10995-023-03773-7.

Antiracist symptom science: A call to action and path forward.

Salomon R, Dobbins S, Harris C, Haeusslein L, Lin C, Reeves K Nurs Outlook. 2022; 70(6):794-806.

PMID: 36400578 PMC: 10916506. DOI: 10.1016/j.outlook.2022.07.014.

Assessing Perception of Prenatal Care Quality Among Black Women in the United States.

Dailey R, Peoples A, Zhang L, Dove-Medows E, Price M, Misra D J Midwifery Womens Health. 2022; 67(2):235-243.

PMID: 35060657 PMC: 10181860. DOI: 10.1111/jmwh.13319.

Experiences of Discrimination and Depression Trajectories over Pregnancy.

Norona-Zhou A, Aran O, Garcia S, Haraden D, Perzow S, Demers C Womens Health Issues. 2021; 32(2):147-155.

PMID: 34774402 PMC: 9701536. DOI: 10.1016/j.whi.2021.10.002.

Intimate partner violence, prenatal stress, and substance use among pregnant Black women.

Zhang L, Dailey R, Price M, Misra D, Giurgescu C Public Health Nurs. 2021; 38(4):555-563.

PMID: 33590543 PMC: 10478037. DOI: 10.1111/phn.12878.

References

Krieger N, Sidney S . Racial discrimination and blood pressure: the CARDIA Study of young black and white adults. Am J Public Health. 1996; 86(10):1370-8. PMC: 1380646. DOI: 10.2105/ajph.86.10.1370. View

Slaughter-Acey J, Talley L, Stevenson H, Misra D . Personal Versus Group Experiences of Racism and Risk of Delivering a Small-for-Gestational Age Infant in African American Women: a Life Course Perspective. J Urban Health. 2018; 96(2):181-192. PMC: 6458205. DOI: 10.1007/s11524-018-0291-1. View

Paradies Y, Ben J, Denson N, Elias A, Priest N, Pieterse A . Racism as a Determinant of Health: A Systematic Review and Meta-Analysis. PLoS One. 2015; 10(9):e0138511. PMC: 4580597. DOI: 10.1371/journal.pone.0138511. View

Bazargan M, Cobb S, Castro Sandoval J, Assari S . Smoking Status and Well-Being of Underserved African American Older Adults. Behav Sci (Basel). 2020; 10(4). PMC: 7226211. DOI: 10.3390/bs10040078. View

Ludman E, Curry S, Grothaus L, Graham E, Stout J, Lozano P . Depressive symptoms, stress, and weight concerns among African American and European American low-income female smokers. Psychol Addict Behav. 2002; 16(1):68-71. DOI: 10.1037//0893-164x.16.1.68. View

Misra D, Strobino D, Trabert B . Effects of social and psychosocial factors on risk of preterm birth in black women. Paediatr Perinat Epidemiol. 2010; 24(6):546-54. PMC: 8173710. DOI: 10.1111/j.1365-3016.2010.01148.x. View

Orr S, Blazer D, James S, Reiter J . Depressive symptoms and indicators of maternal health status during pregnancy. J Womens Health (Larchmt). 2007; 16(4):535-42. DOI: 10.1089/jwh.2006.0116. View

Martin J, Hamilton B, Osterman M, Driscoll A, Drake P . Births: Final Data for 2017. Natl Vital Stat Rep. 2019; 67(8):1-50. View

Giurgescu C, Engeland C, Templin T, Zenk S, Koenig M, Garfield L . Racial discrimination predicts greater systemic inflammation in pregnant African American women. Appl Nurs Res. 2016; 32:98-103. PMC: 5159450. DOI: 10.1016/j.apnr.2016.06.008. View

10.

Drake P, Driscoll A, Mathews T . Cigarette Smoking During Pregnancy: United States, 2016. NCHS Data Brief. 2018; (305):1-8. View

11.

Balkan B, Pogun S . Nicotinic Cholinergic System in the Hypothalamus Modulates the Activity of the Hypothalamic Neuropeptides During the Stress Response. Curr Neuropharmacol. 2017; 16(4):371-387. PMC: 6018196. DOI: 10.2174/1570159X15666170720092442. View

12.

Fluharty M, Taylor A, Grabski M, Munafo M . The Association of Cigarette Smoking With Depression and Anxiety: A Systematic Review. Nicotine Tob Res. 2016; 19(1):3-13. PMC: 5157710. DOI: 10.1093/ntr/ntw140. View

13.

Bruijnzeel A . Tobacco addiction and the dysregulation of brain stress systems. Neurosci Biobehav Rev. 2012; 36(5):1418-41. PMC: 3340450. DOI: 10.1016/j.neubiorev.2012.02.015. View

14.

Orr S, Newton E, Tarwater P, Weismiller D . Factors associated with prenatal smoking among black women in eastern North Carolina. Matern Child Health J. 2005; 9(3):245-52. DOI: 10.1007/s10995-005-0010-x. View

15.

Schreiber J . Update to core reporting practices in structural equation modeling. Res Social Adm Pharm. 2016; 13(3):634-643. DOI: 10.1016/j.sapharm.2016.06.006. View

16.

Plascak J, Hohl B, Barrington W, Beresford S . Perceived neighborhood disorder, racial-ethnic discrimination and leading risk factors for chronic disease among women: California Behavioral Risk Factor Surveillance System, 2013. SSM Popul Health. 2018; 5:227-238. PMC: 6077127. DOI: 10.1016/j.ssmph.2018.07.001. View

17.

Slaughter-Acey J, Sealy-Jefferson S, Helmkamp L, Caldwell C, Osypuk T, Platt R . Racism in the form of micro aggressions and the risk of preterm birth among black women. Ann Epidemiol. 2015; 26(1):7-13.e1. PMC: 4688115. DOI: 10.1016/j.annepidem.2015.10.005. View

18.

Krieger N . Racial and gender discrimination: risk factors for high blood pressure?. Soc Sci Med. 1990; 30(12):1273-81. DOI: 10.1016/0277-9536(90)90307-e. View

19.

Goodwin R, Cheslack-Postava K, Nelson D, Smith P, Wall M, Hasin D . Smoking during pregnancy in the United States, 2005-2014: The role of depression. Drug Alcohol Depend. 2017; 179:159-166. PMC: 5635833. DOI: 10.1016/j.drugalcdep.2017.06.021. View

20.

Krieger N, Carney D, Lancaster K, Waterman P, Kosheleva A, Banaji M . Combining explicit and implicit measures of racial discrimination in health research. Am J Public Health. 2009; 100(8):1485-92. PMC: 2901297. DOI: 10.2105/AJPH.2009.159517. View