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

总结 COVID-19大流行正在显著影响SARS-CoV-2的不良医疗结果风险 感染以及与压力和创伤暴露相关的不良心理健康结果，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， 像COVID-19大流行这样的创伤性事件与疾病恶化和 紧急精神疾病和共病身体健康状况。低收入少数民族人口 社会经济地位受到大流行病的不利影响， 在这些患者中，预先存在的高创伤暴露率和创伤相关不良结局的影响 人口。一群患有不良精神和身体疾病的风险不成比例地高的人 2019冠状病毒病大流行导致的健康后果是怀孕和产后的黑人。重要的是， 黑人产妇健康不良后果的风险增加也可能是由于种族歧视的经历。 歧视一种生物学机制，可能会带来不利的健康结果的风险，在这种情况下， COVID-19和RD在怀孕的黑人中是心理生理上的过度觉醒。自主神经功能增强 对威胁性刺激的反应性以前与创伤/压力暴露、创伤后应激障碍和 全身性炎症加剧，这是一个重要的危险因素，对不良的精神和身体健康的结果， 孕妇和非孕妇。考虑到黑人孕妇和妇女在健康方面的差异， 产后人士，了解COVID-19大流行和RD的影响对孕产妇至关重要 健康，以及后代的健康。目前的研究旨在确定COVID-19大流行的影响， 精神健康、与怀孕有关的发病率和产妇死亡率方面的种族歧视，以及恐惧 心理生理学在怀孕期间和产后三个月的黑人。生成的数据 从这项关于COVID-19大流行和种族歧视对精神和心理影响的及时研究中， 黑人怀孕和产后的身体健康结果将促进我们的知识，并告知 针对未得到充分研究的弱势群体的风险分层方法和缓解战略。

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.