Prenatal cigarette smoking as a mediator between racism and depressive symptoms: The Biosocial Impact on Black Births Study

Objective This study examined whether cigarette smoking mediated the association of racial discrimination with depressive symptoms among pregnant Black women. Design Cross‐sectional. Sample Two hundred Black women at 8–29 weeks gestation. Measurements Women completed questionnaires including the Exp...

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Bibliographic Details
Published in:	Public health Nursing Vol. 37; no. 5; pp. 740 - 749
Main Authors:	Giurgescu, Carmen, Zhang, Liying, Price, Mercedes A., Dailey, Rhonda K., Frey, Heather A., Walker, Deborah S., Zenk, Shannon N., Engeland, Christopher G., Anderson, Cindy M., Misra, Dawn P.
Format:	Journal Article
Language:	English
Published:	United States Wiley Subscription Services, Inc 01-09-2020
Subjects:	Adult Births Black or African American - psychology Black or African American - statistics & numerical data Cigarette smoking Cigarette Smoking - ethnology Cigarettes Cross-Sectional Studies Data collection Depression - ethnology depressive symptoms Discrimination Drug addiction Epidemiology Female Gestation Gestational age Humans Mental depression Pregnancy pregnant women Pregnant Women - ethnology Pregnant Women - psychology Racial discrimination Racism Racism - psychology Smoking Statistical analysis Surveys and Questionnaires Womens health Young Adult cigarette smoking pregnant women depressive symptoms racial discrimination
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Summary:	Objective This study examined whether cigarette smoking mediated the association of racial discrimination with depressive symptoms among pregnant Black women. Design Cross‐sectional. Sample Two hundred Black women at 8–29 weeks gestation. Measurements Women completed questionnaires including the Experiences of Discrimination and the Center for Epidemiologic Studies‐Depression (CES‐D) scales, as well as questions about sociodemographic characteristics and cigarette smoking. Results The mean age of the sample was 26.9 ± 5.7 years and the mean gestational age at data collection was 15.6 ± 5.7 weeks. Approximately 17% of women reported prenatal cigarette smoking; 27% had prenatal CES‐D scores ≥23, which have been correlated with depression diagnoses; and 59% reported ever (lifetime) experiencing discrimination in at least one situation (e.g., at work). Path analysis results indicated that the standardized indirect effect of experiences of racial discrimination on CES‐D scores through prenatal smoking was statistically significant (standardized indirect effect = 0.03; 95% CI: 0.001, 0.094; p = .042). Conclusion Cigarette smoking during pregnancy partially mediated the association between lifetime experiences of racial discrimination and prenatal depressive symptoms among pregnant Black women. Smoking cessation programs should focus on identifying and treating depressive symptoms among pregnant Black women.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0737-1209 1525-1446
DOI:	10.1111/phn.12780