Observational studyJournal of obstetric, gynecologic, and neonatal nursing : JOGNN2025
Effects of Sociospatial Inequality on Exposure to Stress, Symptoms of Depression, and Cortisol Rhythms in Pregnancy.
Observational study in Journal of obstetric, gynecologic, and neonatal nursing : JOGNN, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo investigate the effect of sociospatial inequality on exposure to stress, symptoms of depression, and cortisol rhythms during pregnancy.
designSecondary analysis of a cross-sectional observational study.
settingOutpatient women's health clinic in an urban midwestern region of the United States.
participantsPregnant women in the second trimester of pregnancy (N = 67).
methodsWe performed a secondary analysis of salivary cortisol samples to compute average daily cortisol rhythms (diurnal slope, area under the curve, mesor, amplitude, and acrophase). We measured sociospatial inequality using the index of concentration at the extremes based on zip-code-level data from the American Community Survey. We used mixed-effects cosinor regression to examine the association among sociospatial inequality, exposure to stress, symptoms of depression, and cortisol rhythms, adjusting for multiple covariates.
resultsSociospatial inequality was significantly associated with demographic variables (age, race, and education) and mental health variables (exposure to stress and symptoms of depression). We found a statistically significant curvilinear association between income-related sociospatial inequality and cortisol rhythms.
conclusionsParticipants who lived in areas of extreme income-related deprivation and privilege had higher amplitude cortisol rhythms, which potentially reflects heightened biological sensitivity to context, whereas women living in more moderate environments showed buffered cortisol rhythms.
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