Discrimination is associated with poor sleep quality in pregnant Black American women

• Type of Material: Article
• Authors: Madeleine F. Cohen, Emory University; Elizabeth J. Corwin, Columbia University; Dayna A. Johnson, Emory University; Alexis Amore, Emory University; April L. Brown, Emory University; Nia Barbee, Emory University; Patricia Brennan, Emory University; Anne Lang Dunlop, Emory University
• Language: English
• Date: 2022-08-09
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2022 Elsevier B.V. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): https://doi.org/10.1016/j.sleep.2022.07.015
• Title of Journal or Parent Work: Sleep Medicine
• Volume: 100
• Start Page: 39
• End Page: 48
• Grant/Funding Information: This study was supported by the National Institutes of Health, National Institute of Nursing Research [R01NR014800], National Institute of Environmental Health Sciences [R24ES029490], Office of the Director [UH3OD023318] and the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH) under Award number UL1TR002378.
• Keywords: Prenatal sleep quality; Racial/ethnic discrimination; Sleep quality; Pregnancy
• Research Categories: Health Sciences, Public Health; Health Sciences, Obstetrics and Gynecology

Abstract

Background: Heightened exposure to racial/ethnic discrimination is associated with poorer sleep health among non-pregnant adults. This relationship has received limited research attention among pregnant women, despite the importance of prenatal sleep quality for optimal maternal and child health outcomes. Methods: We utilized perinatal data from a sample of Black American women (n = 600) participating in a cohort study who reported their lifetime experiences of racial/ethnic discrimination and gendered racial stress during early pregnancy and reported on their sleep quality and depressive symptoms during early and mid-pregnancy. Hierarchical multiple linear regression models were fit to examine associations between lifetime experiences of racial/ethnic discrimination or gendered racial stress and sleep quality during early and mid-pregnancy. We also adjusted for women’s concurrent depressive symptoms and tested whether the discrimination/sleep quality association varied by socioeconomic status. Results: Greater exposure to racial/ethnic discrimination was associated with poorer sleep quality during early (ΔR2 = 0.04, ΔF = 26.08, p < 0.001) and mid-pregnancy (ΔR2 = 0.02, ΔF = 9.88, p = 0.002). Similarly, greater gendered racial stress was associated with poorer sleep quality during early (ΔR2 = 0.10, ΔF = 65.72, p < 0.001) and mid-pregnancy (ΔR2 = 0.06, ΔF = 40.43, p < 0.001. These findings largely held after adjustment for concurrent prenatal depressive symptoms. Socioeconomic status did not modify the observed relationships. Conclusions: Efforts to decrease institutional and interpersonal experiences of racial/ethnic discrimination and gendered racism would benefit the sleep quality of pregnant Black American women, particularly during early pregnancy.