Journal of Racial and Ethnic Health Disparities

, Volume 6, Issue 6, pp 1208–1217 | Cite as

Systematic Review of Chronic Discrimination and Changes in Biology During Pregnancy Among African American Women

  • Carlye ChaneyEmail author
  • Marcela Lopez
  • Kyle S. Wiley
  • Caitlin Meyer
  • Claudia Valeggia


Profound racial health disparities in maternal and infant health exist in the USA. Discrimination based on race may contribute to these disparities, but the biological pathways through which racial discrimination acts on health are not fully known. Even less is known about these pathways during development. Examining how racial discrimination becomes biology is paramount because it may shed light on how and when such social forces result in lasting biological consequences for health and wellbeing. To begin exploring this issue, we performed a systematic review of the relationships between experiences of chronic racial discrimination and relevant biomarkers measured during pregnancy among African American women. The literature search included studies published prior to August 2018 in the MEDLINE, Embase, and PsycINFO databases, and 11 studies met our inclusion criteria. We evaluated the articles based on the biological system that the authors investigated, which included the immune, neuroendocrine, and cardiovascular systems. We found that the current literature provides preliminary evidence that experiences of chronic racial discrimination are associated with changes in maternal biology during pregnancy. However, the literature was limited in both quantity and quality. We found only 11 studies that addressed this subject, four of which only provided indirect evidence, and many studies had small sample sizes. Future work in this area should develop more informative methods that consider the interaction between interpersonal and structural racial discrimination, individual variation, and sociocultural factors. We conclude researchers should continue to work in this area and focus on developing more effective study designs and larger sample sizes.


Racial discrimination Maternal health Pregnancy outcomes 



We thank Kendall Arslanian, Katherine Daiy, Victoria Harries, and Stephanie Levy for their comments on various drafts of this manuscript.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Supplementary material

40615_2019_622_MOESM1_ESM.docx (19 kb)
ESM 1 (DOCX 16 kb)


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Copyright information

© W. Montague Cobb-NMA Health Institute 2019

Authors and Affiliations

  1. 1.Department of AnthropologyYale UniversityNew HavenUSA
  2. 2.Harvey Cushing/John Hay Whitney Medical LibraryYale UniversityNew HavenUSA

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