The unique contribution of gendered racial stress to depressive symptoms among pregnant Black women.
The unique contribution of gendered racial stress to depressive symptoms among pregnant Black women.
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DOI：
10.1177/17455057221104657
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发表时间：
2022-01
期刊：
影响因子：
2.4
通讯作者：
Hogue, Carol J. Rowland
中科院分区：
文献类型：
--
作者：
Clarke, Lasha S.;Riley, Halley E. M.;Corwin, Elizabeth J.;Dunlop, Anne L.;Hogue, Carol J. Rowland
怀孕的黑人妇女面临着不成比例的不良分娩结局风险，部分原因是压力更大。压力会增加患抑郁症的风险，抑郁症是早产的已知风险因素。此外，压力的多个维度，包括感知到的压力和应激性生活事件，都与不利的分娩结果有关，而与产前抑郁无关。我们使用跨部门和情境化的性别种族压力测量来评估性别种族压力是否构成了产前抑郁的一个额外维度，独立于应激生活事件和感知到的压力。在这项对428名黑人女性的横断面研究中，我们评估了性别种族压力(使用由39个条目组成的Jackson Hogue Phillips Reduced Common Confactualized压力测量工具)、感知压力(使用感知压力量表)和应激性生活事件(使用压力生活事件指数)作为抑郁症状的心理社会预测因子(由爱丁堡抑郁量表测量)。我们使用双变量分析和多变量回归来评估压力测量和产前抑郁之间的关联。结果显示，参与者在杰克逊·霍格·菲利普斯简明情境化压力测量及其5个子量表和爱丁堡抑郁量表上的得分之间存在显著的双变量关联。在包括参与者感知压力量表和/或压力生活事件指数得分的多变量模型中，杰克逊·霍格·菲利普斯减少共同情境化压力测量对爱丁堡抑郁量表得分的贡献是唯一和显著的，其中负担子量表是所有变量中最大的贡献者。在多变量模型中没有发现显著的社会人口学特征。对于怀孕早期的黑人女性来说，性别种族压力是与抑郁症状增加相关的压力的一个独特维度。跨部门压力测量可能最好地揭示黑人女性复杂的社会环境中的细微差别。
Pregnant Black women are at disproportionate risk for adverse birth outcomes, in part associated with higher prevalence of stress. Stress increases risk of depression, a known risk factor for preterm birth. In addition, multiple dimensions of stress, including perceived stress and stressful life events, are associated with adverse birth outcomes, independent of their association with prenatal depression. We use an intersectional and contextualized measure of gendered racial stress to assess whether gendered racial stress constitutes an additional dimension to prenatal depression, independent of stressful life events and perceived stress. In this cross-sectional study of 428 Black women, we assessed gendered racial stress (using the 39-item Jackson Hogue Phillips Reduced Common Contextualized Stress Measure), perceived stress (using the Perceived Stress Scale), and stressful life events (using a Stressful Life Event Index) as psychosocial predictors of depressive symptoms (measured by the Edinburgh Depression Scale). We used bivariate analyses and multivariable regression to assess the association between the measures of stress and prenatal depression. Results revealed significant bivariate associations between participant scores on the full Jackson Hogue Phillips Reduced Common Contextualized Stress Measure and its 5 subscales, and the Edinburgh Depression Scale. In multivariable models that included participant Perceived Stress Scale and/or Stressful Life Event Index scores, the Jackson Hogue Phillips Reduced Common Contextualized Stress Measure contributed uniquely and significantly to Edinburgh Depression Scale score, with the burden subscale being the strongest contributor among all variables. No sociodemographic characteristics were found to be significant in multivariable models. For Black women in early pregnancy, gendered racial stress is a distinct dimension of stress associated with increased depressive symptoms. Intersectional stress measures may best uncover nuances within Black women’s complex social environment.
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