Understanding the contributions of stress reactivity to racial disparities in adverse placental and pregnancy outcomes

了解应激反应对不良胎盘和妊娠结局的种族差异的影响

基本信息

批准号：
10636347
负责人：
William Adam Grobman
金额：
$ 73.2万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-04-19 至 2028-02-29
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10636347
关键词：
Affective Black race Blood Pressure Blood Vessels Cardiovascular Diseases Cardiovascular system Cells Child Chronic Disparity Ecological momentary assessment Education Environment Event Exposure to Face Frequencies Future Goals Health Health behavior Histologic Histology Hydrocortisone Hypertension Hypothalamic structure Immune system Income Individual Inequity Inflammation Laboratories Lesion Life Life Cycle Stages Measurement Measures Mediating Mothers Neighborhoods Neurosecretory Systems Not Hispanic or Latino Nulliparity Outcome Participant Physiological Pituitary Gland Placenta Play Population Pregnancy Pregnancy Outcome Pregnant Women Premature Birth Psychological Stress Reaction Reporting Research Resources Risk Salivary Severities Sex Discrimination Small for Gestational Age Infant Socioeconomic Status Stress Stress and Coping Stressful Event Testing Time Weather Woman adverse outcome adverse pregnancy outcome biological adaptation to stress black women black/white disparity cardiovascular disorder risk cardiovascular risk factor coping experience health inequalities heart rate variability immune function insight maternal stress mortality negative affect neonatal morbidity pregnancy disorder prenatal exposure prenatal stress psychologic racial difference racial discrimination racial disparity response social stressor stress reactivity stressor

项目摘要

ABSTRACT A growing number of studies has implicated maternal stress as an explanation for the higher burden of adverse pregnancy outcomes (APOs) seen among non-Hispanic Black women compared with their non-Hispanic White counterparts. Most studies that have explored the relationship between stress and APOs have focused solely on prenatal exposure to stressors, but Black women are generally exposed to more stressors over the life course than White women. Moreover, Black women may have more limited resources to cope with social stressors, as well as be more likely to experience enduring stressors like racial and/or gender discrimination, which may lead to dysregulated physiological and psychological responses to everyday stressors (i.e., stress reactivity). Several studies have shown dysregulated cardiovascular, neuroendocrine, and affective reactivity to stressors is associated with increased CVD risk and other adverse health outcomes in non-pregnant populations, but the impact of dysregulated stress reactivity on pregnancy outcomes remains poorly understood. Thus, the overall goal of this study is to examine the impact of physiological and psychological stress reactivity on adverse placental and pregnancy outcomes. We will use ecological momentary assessments and intensive measurements of heart rate variability, blood pressure, salivary cortisol, and positive and negative affect to generate personalized measures of how pregnant women respond to stressful experiences in their daily lives. We will then examine associations of these measures with adverse placental lesions and pregnancy outcomes. Finally, we will quantify the extent to which stress reactivity and exposure to stressors during pregnancy account for racial disparities in these adverse outcomes.

抽象的越来越多的研究暗示了孕产妇的压力，以解释更大的不利负担与非西班牙裔白人相比，非西班牙裔黑人妇女在怀孕结局（APO）同行。大多数探索压力与APO之间关系的研究仅关注关于产前暴露于压力源，但黑人妇女通常会承受更多的压力源课程比白人妇女。此外，黑人妇女可能有更多有限的资源来应对社会压力源，更有可能体验到种族和/或性别歧视等持久压力源，这可能导致对日常压力源的生理和心理反应失调（即压力反应性）。几项研究表明，心血管，神经内分泌和情感反应性失调压力源与CVD风险增加和非怀孕的其他不良健康结果有关种群，但压力反应失调对妊娠结局的影响仍然很差理解。因此，这项研究的总体目标是检查生理和心理的影响不良胎盘和妊娠结局的压力反应性。我们将使用生态瞬间心率变异性，血压，唾液皮质醇的评估和密集测量积极和负面影响以产生个性化孕妇如何应对压力的措施他们日常生活的经验。然后，我们将检查这些措施的关联病变和妊娠结局。最后，我们将量化压力反应性和暴露于多大程度怀孕期间的压力源是这些不良后果的种族差异。