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

COVID-19 和种族歧视对黑人孕妇和产后心理、身体和心理生理健康的影响

• 批准号: 10393125
• 负责人: Vasiliki Michopoulos
• 金额: $ 33.32万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-10 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10393125
• 关键词: Adverse effects; Affect; Biological; COVID-19; COVID-19 pandemic; Clinic; Clinical; Common Data Element; Computerized Medical Record; Data; Discipline of obstetrics; Discrimination; Domestic Violence; Economics; Equation; Fright; Gynecology; Health; Hospitals; Individual; Interview; Knowledge; Life; Link; Longitudinal cohort; Low Birth Weight Infant; Maternal Health; Maternal Mortality; Measurement; Measures; Medical; Mental Depression; Mental Health; Mental disorders; Minority Groups; Modeling; Morbidity - disease rate; Outcome; Patient Self-Report; Persons; Population; Post-Traumatic Stress Disorders; Postpartum Depression; Postpartum Period; Pregnancy; Premature Birth; Psyche structure; Psychophysiology; Reporting; Research; Risk; Risk Factors; SARS-CoV-2 infection; Series; Social Work; Social isolation; Stimulus; Stress; Stressful Event; Structure; Symptoms; Testing; Time; Trauma; Vulnerable Populations; adverse maternal outcomes; adverse outcome; comorbidity; data harmonization; depressive symptoms; economic impact; electronic data; experience; health care service; health care settings; health disparity; high risk; loved ones; low socioeconomic status; mortality; offspring; pandemic disease; perinatal outcomes; physical conditioning; pregnant; prenatal; psychologic; racial discrimination; recruit; risk stratification; service delivery; severe maternal morbidity; systemic inflammatory response; trauma exposure; trauma symptom; traumatic event

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.

摘要 新冠肺炎大流行对SARS-CoV-2不良医疗结局的风险产生了重大影响 感染以及与压力和创伤暴露相关的不良心理健康后果，例如 抑郁症和创伤后应激障碍(PTSD)。关于大规模危机的数据显示，压力和压力 像新冠肺炎这样的创伤性事件与病情恶化和死亡的风险增加有关 新出现的精神障碍和共病的身体健康状况。洛城的少数民族人口 社会经济地位受到流行病的不成比例的不利影响，这加剧了不利的 先前存在的高创伤暴露率和创伤相关不良后果的影响 人口。精神和身体不良风险高得不成比例的一组人 新冠肺炎大流行造成的健康后果是孕妇和产后黑人。重要的是 黑人产妇不良健康结局的风险增加也可能是由于经历了种族歧视 歧视。一种可能在以下情况下产生不良健康后果风险的生物机制 孕期黑人新冠肺炎和RD是心理生理上的高唤醒。增强自主性 以前，对威胁性刺激的反应与创伤/压力暴露、创伤后应激障碍和 全身性炎症加剧，是#年不利心理和身体健康后果的一个重要风险因素 孕妇和非孕妇。鉴于这些健康差距，布莱克怀孕和 产后者，了解新冠肺炎大流行和RD的影响对孕产妇来说至关重要 健康，以及后代的健康。目前的研究旨在确定新冠肺炎大流行的影响和 心理健康、与怀孕有关的发病率和孕产妇死亡率以及恐惧方面的种族歧视 黑人孕期和产后三个月的心理生理学。生成的数据 从这项关于新冠肺炎大流行和种族歧视对心理和心理健康影响的及时研究 黑人孕妇和产后的身体健康结果将促进我们的知识和信息 针对研究不足的脆弱人群的风险分层方法和缓解战略。