Looking Back to Look Forward: Social Environment Across the Life Course, Epigenetics, and Birth Outcomes in Black Families

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Improving the health outcomes for infants and children has been a national priority in the United States (US) for over a century. Despite great strides in improving perinatal health care and utilization among American women, key perinatal indicators have remained stagnant or worsened, the US continues to rank near the bottom, and racial disparities are persistent. While studies now have gone beyond behavioral and biomedical determinants of health and encompass the social environment, most research still remains focused on the time shortly before or during the pregnancy Improvements in perinatal health will require utilization of frameworks which integrate life-course and multiple-determinant models of health. Though the body of evidence linking the prenatal social environment, particularly maternal stress, and epigenome is growing, little work has yet explored the life course antecedents to the prenatal social environment and the impact on epigenetic methylation or telomere length. Based on our widely embraced framework for perinatal health that marries a multiple determinants model with a life course approach, we will investigate maternal social environmental influences on maternal methylation and telomere length. Change as well as critical periods will be assessed as the maternal social environment over the maternal life course may independently, cumulatively, and interactively impact the maternal epigenomic profile and its changes over the life course. Archived newborn blood spots, available for all pregnant women in this unique cohort of Black births in metro Detroit, will be assayed to determine the presence of epigenetic methylation and telomere length of mothers at their own birth; maternal measures at the index pregnancy will be derived from analogous blood spots collected in our study. Neighborhood level data will utilize both administrative and subjective measures of neighborhood. In addition to determining associations between the maternal social environment and her epigenomic features across her life course, we will endeavor to explore potential pathways linking the social environment and epigenome across the maternal life course with the perinatal outcomes of her offspring. Researchers have recently begun to consider social environmental factors and how they relate to epigenomic features as well as adverse perinatal outcomes. Yet those populations disproportionately affected by these outcomes are grossly underrepresented in genomic studies. Our sample of 1,000 births to Black women, with nearly half expected to women residing in Detroit, will provide a rich source of data on the maternal social environment across the life course and the epigenome. Our team possesses tremendous expertise in the study of perinatal outcomes as well as measures of social environmental factors often overlooked or not modeled in such a way as to provide understanding of mechanisms. Our study will substantially increase evidence about the importance of the maternal social context at multiple points in the life course on her epigenome and birth outcomes in offspring. The work holds promise for significantly increasing understanding about how social factors have influence across generations through epigenetic processes.