Racial Differentials in the Impact of Maternal Cigarette Smoking During Pregnancy on Fetal Development and Mortality: Concerns for Black Psychologists

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Abstract
Data from more than 60,000 births in the United States were reevaluated by statistical power analysis to determine if racial differentials existed in the impact of maternal cigarette smoking during pregnancy on low birth weight and infant mortality. The risk of mortality was significantly greater for infants of Black maternal smokers than Black nonsmokers. But the same relationship was not evident for Whites. The most dramatic increase in mortality was exhibited among infants of Black mothers who smoked more than one pack of cigarettes per day. Recent estimates indicate that the rate of smoking among pregnant Blacks now surpasses that of Whites, and the number of Black women who smoke more than one pack of cigarettes per day during pregnancy has increased. Racism, sexism, and associated increased levels of psychosocial stress appear to be implicated in the etiology of these racial differentials.