Experiences of adversity, including discrimination, among pregnant women is a substantial public health concern that impacts offspring. The aims of the Healthy Brain and Child Development (HBCD) parent grant are: 1) to examine behavioral, cognitive, biological, social, and emotional aspects of child development prenatally to 10 years of age; and 2) to examine the impacts of sociodemographic factors, stress and mental health, genetics, and prenatal substance exposure on child development. The proposed work will use the first distribution of HBCD data (July 2024) and existing data from the Prevention and Early Adversity Research Lab’s (PEARL) Pregnancy Project, both of which examine the impact of perinatal experiences of adversity on Black women’s postnatal outcomes and the outcomes of their young infants. For Aim 1, the Candidate will examine disparities between Black and White women with substance use histories, using HBCD data from the first data release. We hypothesize that Black women with substance use histories will experience greater prenatal levels of economic stress, food insecurity, adverse neighborhood conditions, and intimate partner violence, as well as lower levels of social support and positive experiences than their white counterparts. We further hypothesize that these adverse experiences will be related to greater postnatal levels of maternal physical health concerns, depression, and stress, and higher levels of infant prematurity and morbidity. For Aim 2, the Candidate will examine the moderating role of discrimination in the relation between Black women’s prenatal experience of adversity and postnatal maternal functioning. Using the PEARL Pregnancy Project data set of Black women from low-income backgrounds, we hypothesize that discrimination will moderate the relation between an index of adverse experiences during pregnancy (i.e., demographic risks including household size, immigration status, marital status, education level, receipt of Public Assistance; maternal exposure to trauma; and environmental chaos) and maternal health outcomes (i.e., physical health, depression). For the HBCD dataset, we hypothesize that discrimination will moderate the link between adverse experiences during pregnancy (i.e., economic stress, food insecurity, neighborhood safety, intimate partner violence, social support, positive experiences) and maternal functioning (i.e., physical health, depression, stress). The Candidate’s work will provide a better understanding of Black/White racial disparities with respect to the experiences and outcomes of women with substance use histories, as well as the unique experiences of Black women that lead to adverse maternal and infant outcomes. This training project will help accelerate the Candidate’s transition to doctoral studies and her research career trajectory. This study is part of the NIH’s Helping to End Addiction Long-term (HEAL) initiative to speed scientific solutions to the national opioid public health crisis. The NIH HEAL Initiative bolsters research across NIH to improve treatment for opioid misuse and addiction.

Project Narrative Experiences of adversity, including racism and discrimination, among pregnant women is a substantial public health concern that impacts their functioning and outcomes in their offspring. The proposed supplement examines Black/White racial disparities in perinatal experiences and outcomes among women with substance use histories, as well as the interaction of discrimination and perinatal adversity on Black women’s functioning. This work will provide a better understanding of the effects of pre- and postnatal factors that impact maternal functioning and infant health and developmental outcomes.