Reproductive
Vicarious trauma: A pre-post analysis of exposure to a racially motivated mass shooting and adverse birth outcomes in South Carolina Abigail Kappelman* Abigail Kappelman Annie Ro Andrea Henderson Michael G. Smith Claire Margerison Nancy Fleischer
Introduction: We hypothesized that the mass shooting of Black churchgoers in Charleston, SC on June 17, 2015, constituted a racialized exogenous shock that would increase low birth weight (LBW, <2500g) and preterm birth (PTB, <37wks) in SC, with greater effect size for Black vs. White pregnant women and for women in Charleston County vs. the rest of SC.
Methods: We estimated the association between exposure to the event and adjusted odds of LBW and PTB using singleton birth certificates from SC from 2012-2016. Exposed infants were in utero on June 17, 2015 (estimated month of conception Sept 2014-June 2015); controls were in utero during the same periods the two years prior. Logistic regressions were adjusted for month and year of conception, trimester on event date, maternal race and age, and infant sex. Effect modifiers were maternal Black/White race and residence (Charleston Co./the rest of SC).
Results: We found no association between exposure and LBW (aOR 1.08 [95%CI 0.96-1.21]) or PTB (0.99 [0.89-1.11]) in the entire state (n=104471); associations did not differ by maternal race (both F test p>0.05). In Charleston Co. (n=9398), exposure was associated with higher odds of LBW (aOR 1.70 [95%CI 1.16-2.50]); this association did not differ by race (F test p>0.05). We did not find an association between exposure and PTB in Charleston Co. (aOR 1.29 [95%CI 0.90-1.86]) nor differences by race (F test p>0.05). In the rest of SC, though we found no overall association (LBW aOR 1.04 [95% 0.92-1.17]; PTB 0.97 [0.87-1.09]), we found a marginally harmful association for Black women only (LBW exposed x NHB aOR 1.12 [95%CI 1.01-1.24]; PTB exposed x NHB 1.12 [1.02-1.24]).
Conclusion: Though we found no overall association of exposure to the mass shooting on birth outcomes in SC, we found a significant association between the racialized “shock” and LBW for all pregnant women in Charleston Co., and between exposure and LBW and PTB for pregnant Black women only in the rest of SC.