A systematic review of the relationship between neighborhood stressors, discrimination, and cardiometabolic outcomes during pregnancy

Abstract

Abstract Cardiometabolic outcomes during pregnancy, including hypertensive disorders of pregnancy (HDP) and gestational diabetes, disproportionately affect racial and/or ethnic minority groups in the United States. These disparities are not fully explained by traditional risk factors, but race-related psychosocial stressors such as perceived neighborhood stressors and discrimination (PNSD) may contribute to adverse health outcomes. This systematic review examined the literature on the impact of PNSD on HDP and gestational diabetes. A comprehensive search of PubMed, PsycINFO, Embase, Web of Science, and CINAHL identified 10 eligible studies: seven cohort and three cross-sectional studies. Five studies reported significant associations between PNSD and increased risk for cardiometabolic outcomes during pregnancy (HDP-1 study, gestational diabetes-3 studies, both hypertension and diabetes during pregnancy-1 study). The included studies demonstrated good methodological quality. These findings suggest that PNSD may be associated with cardiometabolic outcomes during pregnancy, but further research is needed, particularly on perceived neighborhood stressors.