Social stressors and inflammation: A mixed methods approach to preterm birth

社会压力源和炎症：早产的混合方法

基本信息

批准号：
10091319
负责人：
Carmen Giurgescu
金额：
$ 56.18万
依托单位：
UNIVERSITY OF CENTRAL FLORIDA
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-01-06 至 2023-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10091319
关键词：
37 weeks gestation Accounting Affect African American Anti-Inflammatory Agents Anxiety Area Biological Markers Birth Birth Rate Blood specimen C-reactive protein Censuses Child Child Health Child Mortality Chronic Disease Chronic stress Data Development Developmental Delay Disorders Emotional Stress Enrollment Event Goals Hair Health Care Costs Hormones Hospital Records Hydrocortisone Incidence Individual Infant Inflammation Inflammatory Interleukin-10 Intervention Interview Knowledge Lead Life Link Longitudinal Studies Measures Mediating Medical Records Methods Mission Modeling Modification Morbidity - disease rate Motor Neighborhoods Neonatal Mortality Not Hispanic or Latino Outcome Pathway interactions Physiological Plasma Pregnancy Pregnancy Outcome Premature Birth Prenatal Structures Psyche structure Questionnaires Race Reporting Research Resources Risk Second Pregnancy Trimester Social Environment Social support Statistical Data Interpretation Stress Structure Third Pregnancy Trimester Time United States National Institutes of Health Woman base clinical practice cohort coping cytokine depressive symptoms design effective intervention health disparity health inequalities high risk high risk population hypothalamic-pituitary-adrenal axis improved improved outcome insight low socioeconomic status metropolitan neighborhood disadvantage physical conditioning pregnant premature prenatal protective effect psychological distress psychosocial racial discrimination racial disparity response social stressor stressor systemic inflammatory response

项目摘要

African American women have 1.5 times the rates of preterm birth (PTB) (<37 weeks completed gestation) compared with non-Hispanic white women. This disproportionately high PTB rate in African Americans is a persistent health inequity that leads to high child mortality, morbidity, and developmental delays. In the U.S. approximately $26 billion are spent annually on health care costs for infants and children that were born prematurely. Recent attempts to explain the high PTB rates in African American women have focused on social stressors, such as disadvantaged neighborhoods, racial discrimination, and stressful life events. These social stressors may lead to PTB by increasing women’s emotional stress levels. Not surprisingly, emotional stress along with levels of the stress hormone cortisol and systemic inflammation - both physiological responses to stress - have all been related to higher risk of PTB. In contrast, one’s psychosocial resources (e.g., social support) can lessen emotional stress and have protective effects on PTB. Little is yet known about the pathways by which social stressors affect inflammation, and ultimately PTB. The objective of the proposed study is to determine how social stressors alter inflammation during pregnancy and lead to PTB in African American women. We aim to: 1) determine the pathways by which social stressors affect PTB; and 2) describe social stressors, emotional stress and psychosocial resources; the associations among these concepts; and their impact on PTB from women’s perspectives. In this longitudinal convergent mixed methods design, we will enroll 1,500 African American women who live in the Detroit metropolitan area. We will collect data on social stressors, emotional stress, and psychosocial resources through questionnaires and administrative (e.g., census) data. This will be done three times prenatally. At these same time points, levels of cortisol and systemic inflammation will be determined from hair and blood samples, respectively. We will also obtain birth data from the prenatal and hospital records. In a subsample of 60 women, semi-structured interviews will be conducted to more specifically understand the associations among social stressors, emotional stress and psychosocial resources; and their impact on PTB. We will conduct a variety of statistical, qualitative and mixed methods analyses using both quantitative and qualitative data to determine answers to the aims of our study. We will also consider the timing of pregnancy in our analyses, as the prenatal data are collected at three distinct time points. The proposed research is highly relevant to NIH’s mission to elucidate mechanisms underlying health disparities in PTB. Insights gained from this mixed methods approach may lead to the development of an individualized PTB risk profile based on a woman's social stressors and biomarkers which will have potential use in clinical practice and be a target for culturally appropriate interventions to reduce PTB incidence in African American women, and will generate new perspectives for future research in other racial groups through our detailed focus on this high risk group.

非洲裔美国妇女的早产发生率（PTB）的1.5倍（<37周完成妊娠）与非西班牙裔白人妇女相比。非洲裔美国人的PTB率不成比例的高度是持续的健康不平等导致儿童死亡率，发病率和发育延迟。在美国每年大约花费260亿美元用于出生的婴儿和儿童的医疗保健费用过早。最近试图解释非洲裔美国妇女的PTB高率的尝试已关注社会压力源，例如处境不利的社区，种族歧视和压力大的生活事件。这些社会压力源可能通过增加女性的情绪压力水平而导致PTB。毫不奇怪，情绪化压力以及应力同性皮质醇和全身注射水平 - 均生理对压力的反应 - 全部与PTB风险更高有关。相反，一个人的社会心理资源（例如，社会支持）可以减少情绪压力，并对PTB产生保护。鲜为人知社会压力源影响创新和最终PTB的途径。提议的目标研究是为了确定社会压力源如何改变怀孕期间注射并导致非洲PTB 美国妇女。我们的目标是：1）确定社会压力源影响PTB的途径； 2）描述社会压力，情绪压力和社会心理资源；这些概念之间的关联；和从妇女的角度来看，它们对PTB的影响。在这种纵向收敛的混合方法设计中，我们将注册1,500名居住的非洲裔美国妇女在底特律大都市地区。我们将收集有关社会压力，情绪压力和社会心理的数据通过问卷和行政（例如人口普查）数据进行资源。这将完成三次产前。在同一时间点，皮质醇和全身性炎症水平将由头发确定和血液样本。我们还将从产前和医院记录中获取出生数据。在将进行60名妇女的子样本，半结构化访谈将被更具体地了解社会压力源，情绪压力和社会心理资源之间的关联；以及它们对PTB的影响。我们将使用定量和定性数据确定我们研究目标的答案。我们还将考虑怀孕的时机我们的分析是在三个不同的时间点收集产前数据的。拟议的研究高度与NIH的使命阐明PTB健康差异的基本机制有关。从中获得的见解这种混合方法方法可能会导致基于A的个性化PTB风险概况的发展女人的社会压力源和生物标志物将在临床实践中有潜在的使用，并成为目标在文化上适当的干预措施以减少非裔美国妇女的PTB发病率，并将产生新的通过我们对这个高风险组的详细关注，在其他种族小组中对未来研究的观点。

项目成果

期刊论文数量（22）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

A Mixed-Methods Study of Experiences During Pregnancy Among Black Women During the COVID-19 Pandemic.

DOI：
10.1097/jpn.0000000000000622
发表时间：
2022-04-01
期刊：
JOURNAL OF PERINATAL & NEONATAL NURSING
影响因子：
1.3
作者：
Dove-Medows, Emily;Davis, Jean;McCracken, Lindsey;Lebo, Lauren;Misra, Dawn P.;Giurgescu, Carmen;Kavanaugh, Karen
通讯作者：
Kavanaugh, Karen

Epigenetic Implications of Neighborhood Disorder and Psychological Distress among Pregnant Black Women.

DOI：
10.1177/01939459231184713
发表时间：
2023-09
期刊：
WESTERN JOURNAL OF NURSING RESEARCH
影响因子：
1.8
作者：
Nowak, Alexandra L.;Anderson, Cindy M.;Zhao, Yihong;Ford, Jodi L.;Mackos, Amy R.;Ohm, Joyce;Tan, Alai;Saadat, Nadia;Misra, Dawn P.;Giurgescu, Carmen
通讯作者：
Giurgescu, Carmen

Methodologic Considerations for Epigenomic Investigation of Preterm Birth in African American Women.

DOI：
10.1177/01939459211030339
发表时间：
2022-01
期刊：
Western journal of nursing research
影响因子：
1.8
作者：
Nowak AL;Giurgescu C;Ford JL;Mackos A;Ohm J;Tan A;Pietrzak M;Anderson CM
通讯作者：
Anderson CM

Relationship with the Father of the Baby and Pregnancy-Related Anxiety among Pregnant Black Women.

DOI：
10.1097/nmc.0000000000000830
发表时间：
2022-07-01
期刊：
MCN-THE AMERICAN JOURNAL OF MATERNAL-CHILD NURSING
影响因子：
2.4
作者：
Hyer, Suzanne;Hu, Wenfang;Hu, Mengtong;Davis, Jean W.;Xie, Rui;Giurgescu, Carmen
通讯作者：
Giurgescu, Carmen

I Wouldn't Let it Get to Me: Pregnant Black Women's Experiences of Discrimination.