459: Racial differences in self-reported and biologic measures of chronic stress in pregnancy

Abstract

Chronic stress has been associated with adverse pregnancy outcomes such as preterm birth. Elevated chronic stress in African-American women may play a role in racial disparities in preterm birth; however, racial differences in maternal stress have not been consistently demonstrated. The objective of this study is to identify differences in self-reported and biologic measures of chronic stress between African-American and Caucasian pregnant women. African-American and Caucasian pregnant women were recruited at an urban university hospital between May 2008 and July 2009. Self-reported stress was measured from 14 to 22 weeks gestation. Blood samples, collected from 14 to 22 weeks and again from 28 to 32 weeks, were analyzed for serum Epstein-Barr Virus (EBV) antibody, C-Reactive Protein (CRP), CRH, and ACTH. 114 (58 Caucasian and 56 African-American) pregnant women were recruited. An equal number of Caucasian and African American women had Medicaid versus private insurance and income was not significantly different by race. African-American women had significantly higher mean CRP levels in the 2nd trimester (2.09 1.07 vs 1.59 .91, p < .01) and 3rd trimester (1.93 1.11 vs. 1.51 1.0, p = .048). African-American women also had significantly elevated ACTH levels in the 2nd trimester (2.94 0.52 vs 2.68 0.53, p = .01) and 3rd trimester (2.85 1.05 vs. 2.41 1.04, p = .03). No differences in EBV or CRH levels were detected. Caucasian women reported higher buffers against stress (p = .04) and African-American women reported higher rates of discrimination (p<.001). Significant differences in self-reported and biologic measures of chronic stress were identified between African American and Caucasian pregnant women regardless of income. African American women had higher levels of CRP and ACTH in the 2nd and 3rd trimester and reported higher rates of discrimination, while Caucasian women reported a higher level of buffers against stress. Future studies should further investigate the racial differences in chronic stress and associations with adverse pregnancy outcomes.