# Associations of In Utero Exposure to Racial Violence and Reproductive Development: The Bogalusa Heart Study

## TL;DR

Exposure to racial violence during pregnancy was linked to earlier puberty in girls and delayed development in boys, highlighting the impact of maternal stress on reproductive health.

## Contribution

This study is the first to link in utero exposure to racial violence with reproductive development outcomes.

## Key findings

- In utero exposure to racial violence was associated with earlier age at menarche in girls.
- Boys exposed in utero showed delayed pubertal development at age 13.
- An imprecise increased risk of miscarriage and fertility issues was observed.

## Abstract

This study seeks to assess the association between in utero exposure to racial violence during the Civil Rights movement and pubertal development and fertility outcomes within the Bogalusa Heart Study population.

Utilizing a prospective cohort design, Bogalusa Heart Study participants born between 1960 and 1970 were categorized based on their gestational age during peak racial violence events in Bogalusa. Exposure was defined as being in utero during the first trimester during February–July 1965. Pubertal development was assessed using age at menarche for girls and Tanner staging at age 13 for boys (n = 1945) and girls (n = 1970). Fertility outcomes, including fertility issues and miscarriage, were obtained by self‐report from the Bogalusa Babies study (2012–2016).

In utero exposure to racial violence was associated with earlier age at menarche in girls (−0.43 years, p < 0.001) and delayed pubertal development in boys (−0.54 Tanner stage at age 13; p = 0.02). An imprecise estimated increased odds of miscarriage (OR = 2.02, 95% CI: 0.92 to 4.47) and fertility issues (OR = 2.66, 95% CI: 0.62 to 11.32) were observed. Analysis by race did not show a significant interaction.

In utero exposure to racial violence during the first trimester of pregnancy was associated with an earlier age at menarche in girls and slower pubertal development in boys. The findings underscore the importance of considering maternal stressors, specifically racial violence, in understanding variations in reproductive development.