Family dynamics, maternal stress, and the biomarkers of healthy pregnancy

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PROJECT SUMMARY Global patterns of unequal progress in economic and human development introduce disparities in health at birth. In the developing world, these changes, accompanied by urbanization, migration, and the nuclearization of households, are also changing the family context into which children are born. Gaps in health at birth are not only because of economic inequality: the social support and social status of mothers in their family contexts are embodied in the health of pregnancies, with consequences for lifelong wellness. However – and despite the importance of these inequalities for public health – because prior population science has lacked the population-level biomarkers needed to understand these processes – a comprehensive understanding of family structure, stress in pregnancy, and disparities in health at birth in the developing world has not previously been possible. In this mentored project, PI Diane Coffey will pursue training in the biomarkers and biological processes of stress in pregnancy in the developing world. Training in population-level biomarker data and stress biology will empower her career as an independent population scientist studying healthy pregnancy as a start to lifelong wellness. The project has three specific aims. Under Aim 1, Coffey will receive mentored training in the use of biomarkers in population-level survey data on pregnant women (blood pressure, obesity, glucose, and hemoglobin), in the biomarkers (cortisol, CRP) and biology of stress in pregnancy, and in biostatistics. She will complete an extensive program of coursework and guided reading, and attend workshops and conferences on biomarkers to analyze data for pregnant populations. Aim 2 is for the PI to conduct within-population studies of consequences of household structures for biomarkers of stress in pregnancy and birth outcomes. One part of Aim 2 will study the importance of three-generation households; another part will investigate the consequences of partner absence. Aim 3 is construct international comparisons and inform theory by comparing outcomes in countries with different forms and intensities of gender discrimination. Achieving these three aims will prepare the PI to apply for future R01 support as an independent population scientist. The resulting research agenda will add new biosocial root causes to existing models of early life health disparities and assessments of the global burden of disease.