Impacts of COVID-19 and racial discrimination on mental, physical, and psychophysiological health in Black pregnant and postpartum persons

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SUMMARY The COVID-19 pandemic is significantly impacting risk for adverse medical outcomes from SARS-CoV-2 infection and for adverse mental health outcomes associated with stress and trauma exposure, such as depression and posttraumatic stress disorder (PTSD). Data on large-scale crises show that stressful and traumatic events like the COVID-19 pandemic are associated with elevated risk of both worsened and emergent psychiatric disorders and co-morbid physical health conditions. Minority populations of low socioeconomic status are disproportionately adversely affected by pandemics, which compound the adverse effects of pre-existing high rates of trauma exposure and trauma-related adverse outcomes in these populations. One group of individuals who is at disproportionately higher risk for adverse mental and physical health outcomes due to the COVID-19 pandemic are pregnant and postpartum Black persons. Importantly, increased risk for adverse maternal health outcomes in Black persons may also be due to experiences of racial discrimination. One biological mechanism that may confer risk for adverse health outcomes in the context of COVID-19 and RD in pregnant Black persons is psychophysiological hyperarousal. Increased autonomic responsivity to threatening stimuli has previously been linked to trauma/stress exposure, PTSD, and heightened systemic inflammation, a significant risk factor for adverse mental and physical health outcomes in pregnant and non-pregnant persons. Given these health disparities experienced by Black pregnant and postpartum persons, understanding the impacts of the COVID-19 pandemic and RD is critical for maternal health, and that of offspring. The current study aims to determine the impact of the COVID-19 pandemic and racial discrimination on mental health, pregnancy-associated morbidity and maternal mortality, and fear psychophysiology during pregnancy and up to three months postpartum in Black persons. The data generated from this timely research on the impact of the COVID-19 pandemic and racial discrimination on mental and physical health outcomes in Black pregnant and postpartum persons will advance our knowledge and inform risk stratification approaches and mitigation strategies for understudied, vulnerable populations.