Effects of Stress and Inflammatory Cytokines on Pregnancy

压力和炎症细胞因子对妊娠的影响

• 批准号: 7254623
• 负责人: Mary E Coussons-Read
• 金额: $ 17.88万
• 依托单位: UNIVERSITY OF COLORADO DENVER/HSC DENVER
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-04-16 至 2009-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7254623
• 关键词: Address; Anti-Inflammatory Agents; Anti-inflammatory; Birth; Blood Circulation; Caucasians; Caucasoid Race; Clinical; Data; Early identification; Equilibrium; Ethnic Origin; Ethnic group; Gestational Diabetes; Goals; Healthy People 2010; Immune system; Infant Mortality; Inflammatory; Laboratories; Low Birth Weight Infant; Lymphocyte; Minority; Outcome; Peripheral; Population; Population Heterogeneity; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnant Women; Premature Labor; Prematurity of fetus; Probability; Production; Psychosocial Factor; Rate; Risk; Role; Sampling; Social support; Stress; Testing; United States; Woman; Work; biobehavior; cytokine; ethnic minority population; experience; health disparity; maternal stress; mathematical model; member; prenatal; prenatal stress; prospective; racial and ethnic

DESCRIPTION (provided by applicant): Poor pregnancy outcomes and complications such as low birthweight, preeclampsia, prematurity, and gestational diabetes continue to be a significant problem in the United States, particularly for women who are members of ethnic minorities. Psychosocial factors contribute to poor pregnancy outcomes, and proinflammatory aspects of the immune system may be involved in these effects. Although work in our laboratory and others supports connections between prenatal stress and poor outcome, the mechanisms of these relationships remain unclear. We hypothesize that that prenatal maternal stress and low social support increase levels of proinflammatory cytokines during pregnancy and that these changes increase the probability of poor pregnancy outcomes. The proposed R21 project extends our preliminary data, which suggests that high stress during pregnancy is related to elevated proinflammatory cytokines and poor outcome, perform comprehensive analyses of the effects of stress on cytokines during pregnancy, to add assessment of the role of social support in this relationship, and to determine the degree to which these changes can be used to make clinically useful predictions of at-risk pregnancies. An important aspect of this project is that we will study an ethnically diverse population (predominately Caucasian women and Latinas) which will extend the usefulness of the work in developing understanding of ethnic disparities in these relationships. This R21 project tests the hypothesis that high stress and low social support increase maternal production of proinflammatory cytokines during pregnancy (Specific Aim 1) and that this increased production is associated with pregnancy complications and poor outcome (Specific Aim 2). Further, a mathematical modeling approach is proposed to begin to determine the possible clinical usefulness of cytokine levels and stress in identifying pregnancies that are at risk for poor outcomes (Specific Aim 3). An additional aspect of the project is beginning to assess the role of maternal ethnicity in these interactions to explore biobehavioral factors that contribute to the disproportionate occurrence of pregnancy complications in minority women. It is clear that maternal stress can alter pregnancy outcome, although these effects are currently not well- understood. This project tests the hypothesis that high prenatal stress increases production of proinflammatory cytokines in pregnant women in a manner which contributes to poor pregnancy outcomes. We will use a prospective approach to assess stress, social support and cytokine production throughout pregnancy to see if these changes are predictive of poor outcome in a large, multi-ethnic sample.

描述（由申请人提供）：妊娠结局和并发症不佳，例如低出生体重，前宾夕法尼亚，早产和妊娠糖尿病在美国仍然是一个重大问题，尤其是对于少数民族成员而言。社会心理因素导致妊娠结局不良，并且免疫系统的促炎方面可能参与这些影响。尽管我们的实验室和其他人的工作支持产前压力与不良结果之间的联系，但这些关系的机制仍然不清楚。我们假设，产前孕产妇的压力和社会支持较低，增加了怀孕期间促炎细胞因子的水平，并且这些变化增加了怀孕不良结果的可能性。拟议的R21项目扩展了我们的初步数据，这表明怀孕期间的高压力与促炎细胞因子的升高有关，而不良的结果对妊娠期间压力对细胞因子的影响进行了全面分析，以增加对这种关系中社会支持的作用的评估，并确定这些变化可用于在临床上预测这些变化的程度。该项目的一个重要方面是，我们将研究种族多样化的人群（主要是高加索妇女和拉丁裔），这将扩大工作在发展这些关系中对种族差异的理解的实用性。该R21项目检验了以下假设：高压力和低社会支持会在怀孕期间增加孕妇促炎细胞因子的产生（特定目标1），并且这种增加的产生与妊娠并发症和不良结果有关（特定目标2）。此外，提出了一种数学建模方法，以开始确定细胞因子水平和压力在识别有差结果风险的妊娠方面的临床实用性（特定目标3）。该项目的另一个方面是开始评估母性在这些相互作用中的作用，以探索有助于少数妇女妊娠并发症不成比例的生物行为因素。显然，孕产妇的压力可以改变妊娠结局，尽管目前尚不清楚这些影响。该项目检验了以下假设：高产前应激会增加孕妇促炎细胞因子的产生，从而导致妊娠结局不良。我们将使用一种前瞻性方法来评估整个怀孕期间的压力，社会支持和细胞因子的产生，以查看这些变化是否可以预测大型多种族样本中的结果不佳。