Researchers at the University of Colorado Anschutz Medical Campus have found that many pregnant Black Americans have low levels of choline, an essential nutrient that aids in prenatal brain development. Stress caused by institutional racism may play a role.

The study, out now in Schizophrenia Bulletin, also found that these low levels of choline were associated with higher levels of the stress hormone cortisol. Higher cortisol induces the mother to hold choline in her liver instead of delivering it to the baby.

“One of the possible causes of higher cortisol and lower choline levels in Black American women is the burden of institutional racism and the chronic subconscious stress that it causes,” said Robert Freedman, MD, professor of psychiatry at the CU Anschutz Medical Campus and the study’s lead researcher.

Women with lower levels of choline delivered on average two weeks prematurely, putting the babies at an increased risk of attention deficit disorder and other childhood mental health problems.