“You have a date when the baby should have been born and when it actually is. You have weight, length of stay at hospital. It’s extremely objective data,” said Kjersti Aagaard, an OB/GYN researcher at Baylor College of Medicine and Texas Children’s Hospital who was not associated with the study.
Complications such as low birth weight and premature birth have been shown to rise with the stress of natural disasters, racism and domestic violence. Friday’s study, however, is unusual in its suggestion that politics can be a risk factor for poor pregnancy outcomes.
More than two years after Trump’s election, researchers say they now have enough data to begin to analyze its consequences on American society and health.
Political scientists have tried to measure Trump’s effect on partisanship and discourse. Social scientists are studying whether he has changed people’s feelings or predispositions about racism, incivility and bullying. Public health experts have focused on the health effects of Trump’s presidency among populations such as youths, women and LGBT communities.
Some of the research has been inconclusive, but the evidence is growing for a possible “Trump effect” on the health of Latinos. And Trump’s intensifying rhetoric, such as telling minority members of Congress to “go back” to countries they came from, has given the scientists’ work more urgency.
“It’s not hard to imagine why there would be increased stress the past few years: the fear of raids, the deportation threats, the tweets every morning, the separation of children from parents. It’s still early, but we’ve seen enough papers at this point that suggest it’s having real-life consequences on health,” said Luis H. Zayas, professor of social work and psychiatry at the University of Texas at Austin. In recent weeks alone, Zayas said, several scientific journals have asked him to review studies on the psychological effects of Trump’s child separation policy.
“The number of papers is just going to be increasing because there’s often a delay with this kind of work,” he said. “You have to let the policy play out, collect data in the field and make sense of it.”
Much of the research on health effects examines physical and mental symptoms linked to increased stress. A Gallup poll recently documented an increase of stress, anger and worry among all Americans, which match or top the highest levels since it began tracking these negative feelings in 2006. Those who disapprove of Trump’s performance were significantly more likely to experience each of those negative emotions, the survey found.
The study on premature births, published in the American Medical Association’s JAMA Network Open, analyzed nearly 33 million births from 2009 to 2017 and determined that there were 3 percent more preterm births than expected among Latina women in the nine months after the election.
Preterm birth is the largest contributor to infant mortality. Extremely preterm babies often have trouble breathing, severe infections and can have developmental problems with their brains, eyes and digestive systems. Even moderately preterm babies often require longer stays in the hospital and more extensive care because of complications. Some negative effects persist into adulthood.
The study’s authors — public health researchers at Johns Hopkins University, Stony Brook University, the University of California at Berkeley and the University of California at San Francisco — pointed out that their findings show the premature birth increase occurred after Trump’s election but do not prove it was caused by the election or the anti-immigration policies proposed and enforced shortly afterward.
Scott Sullivan, a maternal-fetal medicine professor at the Medical University of South Carolina, who was not involved in the study, cautioned against blaming Trump’s election.
“The study doesn’t show that. It shows a time frame, but a lot of things happen in a time frame in a country as large as ours,” Sullivan said, noting there could be a number of alternative causes, including changes to insurance coverage that could have hindered access to adequate prenatal care.
But any increase in preterm birth is alarming, Sullivan said. “We need to find out what the cause is,” he said.
The lead author of the study noted that it follows other studies that suggest a link to Trump. “It’s not just one piece of evidence,” said Alison Gemmill of the Johns Hopkins Bloomberg School of Public Health. “I think we’re triangulating with all of this evidence that’s coming out, and it’s all more or less telling the same story.”
If anything, the new JAMA study may be underestimating the effect of Trump, said Nancy Krieger, an epidemiologist at Harvard’s School of Public Health who was not involved in the research. Last year, she published a similar study on births in New York that found an increase in preterm births among Latina mothers born outside the United States.
“There’s a price being paid for all the hateful rhetoric we’re hearing now,” Krieger said. “It’s not a game or just words. The words are meant to induce fear, and fear carries a physical toll in our bodies.”
A study of nearly 25,000 births in Texas noted a correlation between anti-immigrant rhetoric during Trump’s 2016 campaign and Latina women waiting longer to seek prenatal care and seeking care less often.
Two other studies found a relationship between fear of immigration raids and negative outcomes among pregnant Latina women. In one, University of Michigan researchers studied birth records before and after a 2008 immigration raid at a meat-processing plant in Iowa involving hundreds of Latinos. They found that babies born to Latina mothers in Iowa in the nine months after the raid suffered a greater risk of premature birth and low birth weight.
Beyond pregnancies, other studies have found increased fear, anxiety and anger among Latino youths since Trump’s election. One pediatric study of nearly 400 U.S.-born adolescents with at least one immigrant parent found increased blood pressure and problems sleeping. Another looking at more than 200 Latino parents noted increased psychological distress.
A paper published last year in the Annals of Behavioral Medicine found a correlation between deportation worries and higher blood pressure among Latina women, as well as a greater risk of obesity.
Taken together, some researchers say, the growing body of work suggests Trump’s short-term strategy of fanning immigration fears for political gains could be causing health problems.
“The sad thing is, given the climate we’re in, I don’t think these studies will convince anyone on either side. We know what separating children from the parents does to children’s brains. But that didn’t stop it from happening,” said Zayas, the University of Texas professor.
Still, it’s important to document the impact of political decisions on public health, he said. “The research being done now is laying the foundation for advocacy, for legal arguments and for the future so that maybe this doesn’t have to happen again.”