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


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.

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Fig. 1
Fig. 2



African American


Birth weight


Confidence interval


Family Resource Scale


Gestational age


Odds ratio


Prenatal care


Preterm birth


Standard deviation


Small-for-gestational age


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This research was supported by NIH grant R01 HD038098 to Dr. Misra. The NIH took no role in any part of the study, including the design or conduct of the study; the collection, management, analysis, or interpretation of the data; the preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. Support was also provided by the Drexel University to Dr. Slaughter-Acey.

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Correspondence to Jaime C. Slaughter-Acey.

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Slaughter-Acey, J.C., Talley, L.M., Stevenson, H.C. et al. 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 96, 181–192 (2019).

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  • Life course
  • Emerging adults
  • Racism
  • African Americans
  • Adverse birth outcomes
  • Birth weight
  • Gestational age