(P10-086-24) Interplay of Structural Violence, Environmental Stressors, and Anemia as Multiple Pathways to Depressive Symptoms Among Pregnant Women in Chicago

Objectives: Chronic exposure to structural violence and environmental stressors interact with biological processes, dysregulating the stress response to drive maternal-infant health disparities in pregnant people. Although studies have shown relationships between anemia and depressive symptoms, and structural/environmental stressors and depressive symptoms, the interplay among these factors is unclear. We examine the associations of neighborhood-level major crime, traffic intensity, traffic crashes, neighborhood safety, and ambient particulate matter on maternal depressive symptoms during first pregnancy encounter and explore this relation in pregnant people with anemia.

Methods: Data from 2015 to 2019 was extracted retrospectively from electronic health records of pregnant patients aged 18-55. Environmental data from the Chicago Health Atlas were linked to each patient’s address. Pearson’s correlations were determined between maternal hemoglobin, environmental stressors, and depressive symptoms (using PHQ-9).

Results: In a sample of 1,975 pregnant people seeking care at an urban health center in Chicago, the mean age was 31± 6.3 years, with 56% non-Hispanic Blacks, 27% Hispanic, 9% non-Hispanic White, 4% non-Hispanic Asian and 4% Non-Hispanic other/Native American. Anemia prevalence was 13% (n=259), and 16% (n=313) reported depressive symptoms (PHQ-9 ≥10). There were no relationships between hemoglobin and depressive symptoms or depressive symptoms and environmental stressors. However, among a subset of patients classified as having anemia (Hb < 11 g/dl), we found significant relationships between environmental stressors and depressive symptoms. Increased neighborhood major crime (r:0.128, p=0.04), traffic intensity (r:0.186, p< 0.01), and traffic crashes (r:0.155, p=0.01) correlated with increased depressive symptoms at first encounter in pregnancy.

Conclusions: Environmental stressors including major crime, traffic intensity, and traffic crashes are related to depressive symptoms in pregnant people with anemia. We will further explore these pathways to depressive symptoms using mixed modeling.

Funding Sources: N/A