Personal Versus Group Experiences of Racism and Risk of Delivering a Small-for-Gestational Age Infant in African American Women: a Life Course Perspective

J Urban Health. 2019 Apr;96(2):181-192. doi: 10.1007/s11524-018-0291-1.


The majority of studies investigating the relationship between racism/racial discrimination and birth outcomes have focused on perceived experiences of racism/racial discrimination directed at oneself (personal racism). However, evidence suggests individuals report with greater frequency racism/racial discrimination directed at friends, family members, or other members of their racial/ethnic group (group racism). We examined how much African American (AA) women report lifetime experiences of perceived racism or racial discrimination, both personal and group, varied by maternal age. We also investigated whether reports of personal and group racism/racial discrimination were associated with the risk of delivering a small-for-gestational age (SGA) infant and how much maternal age in relation to developmental life stages (adolescence [≤ 18 years], emerging adulthood [19-24 years], and adulthood [≥ 25 years]) moderated the relationship. Data stem from the Baltimore Preterm Birth Study, a hybrid prospective/retrospective cohort study that enrolled 872 women between March 2000 and July 2004 (analyzed in 2016-2017). Spline regression analyses demonstrated a statistically significant (p value for overall association < 0.001) and non-linear (p value = 0.044) relationship between maternal age and the overall racism index. Stratified analysis showed experiences of racism overall was associated with a higher odds ratio of delivering an SGA infant among AA women aged ≥ 25 years (OR = 1.45, 95% CI 1.02-2.08). The overall racism index was not associated with the SGA infant odds ratio for emerging adults (OR = 0.86, 95% CI 0.69-1.06) or adolescents (OR = 0.92, 95% CI 0.66-1.28). Multiple aspects of racism and the intersection between racism and other contextual factors need to be considered.

Keywords: Adverse birth outcomes; African Americans; Birth weight; Emerging adults; Gestational age; Life course; Racism.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Baltimore
  • Black or African American / psychology*
  • Black or African American / statistics & numerical data
  • Ethnicity / psychology*
  • Ethnicity / statistics & numerical data
  • Female
  • Gestational Age*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Odds Ratio
  • Pregnancy
  • Premature Birth / psychology*
  • Prospective Studies
  • Racial Groups / psychology*
  • Racial Groups / statistics & numerical data
  • Racism / psychology*
  • Racism / statistics & numerical data
  • Retrospective Studies
  • Risk Factors
  • Young Adult