Doctoral Dissertation Research: Cultural-Biological Research on Stress and Gestational Age

该奖项支持的研究将通过母亲的压力和怀孕结果，特别是早产，来调查文化和生物学之间的关系。先前的研究表明，早产率以及新生儿健康的一些差异可归因于社会和文化因素。然而，人们对贫困、种族主义和其他社会决定因素与分娩胎龄之间的联系机制知之甚少。俄勒冈州立大学（Oregon State University）人类学博士生霍莉·霍兰（Holly Horan）将在梅丽莎·切尼（Melissa Cheyney）博士的指导下，调查母亲压力可能是一个联系因素的可能性。这是一个重要的问题，因为在全球范围内，估计每年有1500万婴儿早产。早产被定义为妊娠37周之前的活产，是五岁以下儿童死亡的主要原因，并与分娩后幸存儿童的终身慢性健康问题有关。这项研究将在波多黎各进行，那里是美国辖区内早产率最高的地方。此外，其他地方与早产有关的最常见流行病学变量（如产妇年龄、吸烟、产妇教育、孕早期产前护理和缺乏医疗保险）并不能解释波多黎各的早产率。然而，最近，研究人员提出了一种新的研究途径：母亲压力和早产之间可能存在的关系，尽管迄今为止，由于方法上的限制，这些研究的结果一直模棱两可。因此，Horan将改进压力研究方法，以便更可靠地描述和检查文化和生物因素之间的关系。她将混合使用社会和生物学方法收集数据，包括：参与性观察；管理波多黎各版科恩感知压力量表（PSS）和修订产前痛苦问卷（RPDQ）；毛发皮质醇浓度（HCC）采样；以及半结构化的产后离职面谈。她将通过对最初25名参与者的探索性半结构化访谈来确定母亲压力的文化模型。另外100名妇女将在妊娠期间（10至12周、22至24周和34至36周）的三个时间点评估PSS、RPDQ和HCCs，以确定妊娠三个月时压力经历和激素的趋势。将在产后4至8周进行一次离职面谈，并从这100名参与者中收集第四次也是最后一次头发皮质醇样本。毛发皮质醇浓度（HCCs）将用于研究一种简单的、非侵入性的皮质醇测量方法作为母亲压力经历的纵向、生物学代理的效用。这项研究有可能导致更全面地了解与产妇压力和母婴健康状况不佳相关的社会和结构病因。这些发现将会引起政策制定者和研究人员的兴趣，他们试图了解社会、文化和生物学之间的联系。

The research supported by this award will investigate the relationship between culture and biology through the lens of maternal stress and pregnancy outcomes, particularly pre-terms births. Previous research has shown that some of the variability in rates of premature birth and thus the health of newborn babies can be attributed to social and cultural factors. However, little is known about the mechanisms that connect poverty, racism, and other social determinants with gestational age at delivery. Oregon State University anthropology doctoral student, Holly Horan, with the supervision of Dr. Melissa Cheyney, will investigate the possibility that maternal stress may be one linking factor. This is an important problem because globally, an estimated 15 million infants are born preterm each year. Preterm delivery, defined as a live-birth before 37 weeks gestational age, is a leading cause of death among children under five years of age, and is associated with lifelong, chronic health issues for those children who survive delivery. The research will be carried out in Puerto Rico which has the highest rate of preterm birth in the entire U.S. jurisdiction. Furthermore, the most common epidemiological variables linked to preterm birth (such as maternal age, smoking, maternal education, first trimester pre-natal care, and lacking health insurance) in other places do not account for the rate in Puerto Rico. Recently, however, researchers have suggested a new avenue of inquiry: a possible relationship between maternal stress and early delivery, although to date, findings from these studies have been equivocal due to methodological constraints. Therefore, Horan will refine stress research methods in order to more reliably characterize and examine relationships between cultural and biological factors. She will collect data with a mix of social and biological methods, including: participant observation; administering the Puerto Rican version of the Cohen Perceived Stress Scale (PSS) and the Revised Prenatal Distress Questionnaire (RPDQ); hair cortisol concentration (HCC) sampling; and semi-structured postpartum exit interviews. She will identify cultural models of maternal stress using exploratory, semi-structured interviews with an initial 25 participants. The PSS, RPDQ, and HCCs will be assessed at three points during gestation (10 to 12 weeks, 22 to 24 weeks, and 34 to 36 weeks) in an additional 100 women in order to identify trends in stress experiences and hormones by trimester. An exit interview will be conducted between four to eight weeks postpartum and a fourth and final hair cortisol sample will be collected from these 100 participants. Hair cortisol concentrations (HCCs) will be used to investigate the utility of a simple, non-invasive cortisol measure as a longitudinal, biological proxy of maternal stress experiences. This study has the potential to result in a more comprehensive understanding of the social and structural etiologies associated with maternal stress and poor maternal and infant health outcomes. These findings will be of interest to policy makers as well as to researchers who seek to understand the connections between society, culture, and biology.