PREGNANT women subjected to interpersonal racial discrimination are nearly 40% more likely to experience postpartum depression and have a more than 170% higher risk of delivering a baby with a very low birth weight (LBW), a 2026 systematic review has found.
Based on the findings, researchers reported that racial discrimination is a modifiable determinant of maternal and neonatal health and should be integrated into perinatal research and care to reduce inequalities.
Adverse Maternal and Neonatal Outcomes
Authors analysed self-reported racial discrimination among pregnant or previously pregnant women, across 3 decades of research.
They examined hypertensive disorders of pregnancy, gestational diabetes, mode of delivery, postpartum depression, fetal growth and gestational outcomes, infant mortality, and neonatal intensive care unit admission.
A total of more than 20,300 records, including nearly 1.5 million participants were identified.
Evidence was strongest for postpartum depression, with women who have experienced racial discrimination at a 37% higher risk.
They were also at a 121% increased risk of delivering a baby with LBW and 170% more likely to deliver a baby with a very LBW.
No associations were reported for hypertensive disorders of pregnancy or gestational diabetes.
Cohort studies exhibited no association between racial discrimination and preterm birth, whereas cross-sectional studies found a 19% increased risk.
Evidence for the other relevant outcomes was inconsistent, researchers noted.
Pathways to Association
Researchers analysed the individual-level exposure to racism in everyday interactions, suggesting that pathways such as psychosocial stressors rooted in racism are likely to contribute to established inequities in populations minoritised through processes of racialisation.
They commented that experiences of interpersonal racial discrimination may contribute to postpartum depression through prolonged stress, social isolation, and strained relationships during pregnancy and the postpartum period.
The association between LBW and racial discrimination could be influenced through maternal stress, placental dysfunction, metabolic dysregulation, and inflammatory processes, researchers submitted.
Discrimination as a Public Health Issue
Authors emphasised the importance of routine assessment of social stressors in perinatal care, alongside mental health screening during pregnancy and the postpartum period.
Current clinical guidelines rarely address racial discrimination explicitly as a risk factor for maternal and neonatal health.
The magnitude and consistency of the associations found warrant systematic attention, researchers reported.
They called for, at the policy level, structural interventions that address discrimination as a public health issue, rather than an individual experience.
Reference
Adesunkanmi M et al. Self-reported experiences of interpersonal racial discrimination and maternal and neonatal health: a systematic review and meta-analysis. Front Reprod Health. 2026;8:DOI:10.3389/frph.2026.1783126.
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