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Racial Disparities in Birthing-Parent Perinatal Mental Health and Child Developmental Outcomes in Response to COVID-19

Wed, April 7, 10:00 to 11:30am EDT (10:00 to 11:30am EDT), Virtual

Abstract

Introduction: Since March 2020, residents of Portland, Oregon have endured a unique combination of major stressful events: COVID-19 restrictions, nightly protests against police brutality/racism, controversial involvement by federal agents, and devastating wildfires that blanketed the region in hazardous air for over a week. What effect has exposure to these stressors had on birthing-parent perinatal mental health and child development? Are certain groups differentially impacted by such events? In particular, has race amplified or dampened risk?

In the United States, COVID-19 has disproportionately affected people of color (CDC, 2020). Additionally, since nationwide protests began after the death of George Floyd on May 25, Black Americans have become significantly more likely to report discrimination as a significant source of stress (APA, 2020). This study will examine the effects of these combined stressors on birthing-parent perinatal mental health and the early physical/social-emotional development of children to evaluate the following:

1.Cumulative load hypothesis: Is change in birthing-parent anxiety/depression in response to these stressors different for individuals who were exposed to one vs. several of these stressors?
2.Race-moderation hypotheses
A)For parents: Is stressor-related change in birthing-parent symptomatology moderated by child race?
B)For children: Does child race moderate the effects of changes in birthing-parent symptomatology on child development?

Method: Data will come from an ongoing longitudinal cohort. Birthing-parent symptomatology is assessed in the 2nd and 3rd trimester, and at 1-,6-, and 12-months postpartum using the Penn State Worry Questionnaire (PSWQ; Meyer et al., 1990), Beck Anxiety Inventory (BAI; Beck et al., 1993), Edinburgh Postnatal Depression Scale (EPDS; Cox et al., 1987), and the Center for Epidemiological Studies Depression Scale (CES-D; Radloff, 1977). Birthing-parent and child race/ethnicity is assessed via self-report. Birth outcomes come from medical charts. At 6- and 12-months postpartum, birthing-parents complete the Ages and Stages Questionnaire (ASQ; Bricker et al., 1999) and Infant Behavior Questionnaire (Gartstein et al., 2003), and birthing-parent-child dyads participate in laboratory assessments of child temperament (Still Face, Arm Restraint; Goldsmith & Rothbarth, 1999).

Data collection began November 2018 and is ongoing. We will use statistical techniques (e.g. regression, structural equation modeling, latent curve modeling) to test our hypotheses. Covariates include income, education, and child sex. Missing data will be handled using FIML. Multiple comparison correction will be applied, as appropriate. By March 2021, 2nd trimester data will be available for N=300, 3rd trimester=282, birth=264, 6-month=188, 12-month=103, making analysis feasible. We project that 20% of birthing-parents and 30% of children will be non-white.

Preliminary results, using data collected before and after March 2020, support our hypotheses. Parents of Black children were more likely to report perinatal depression/anxiety than parents of non-Black children (Table 1). Further, results from a multiple regression suggest that the effect of birthing-parent anxiety/depression on child development is moderated by child racial/ethnic minority status(p=.036). Controlling for child sex and concurrent birthing-parent worry (PSWQ), greater 3rd trimester worry was associated with lower 6-month ASQ gross motor scores, but only for racial/ethnic minority children. This study is needed to determine the impact of the 2020 events on these disparities.

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