Preterm Birth: Psychoneuroimmunology in Hispanics

早产：西班牙裔的心理神经免疫学

• 批准号: 6545355
• 负责人: Roberta Jeanne Ruiz
• 金额: $ 41.75万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-07-01 至 2006-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6545355
• 关键词: Hispanic Americans; adolescence (12-20); behavioral /social science research tag; body composition; clinical research; corticotropin releasing factor; cortisol; estrogens; female; gestational age; hormone regulation /control mechanism; human middle age (35-64); human subject; inflammation; interleukin 1; interleukin 10; interleukin 6; mathematical model; model design /development; patient oriented research; pregnancy; progesterone; psychological stressor; psychoneuroimmunology; social support network; socioeconomics; stress; substance abuse related disorder; tumor necrosis factor alpha; women's health; young adult human (21-34)

DESCRIPTION: (provided by applicant) Low birth weight (LBW) related to preterm birth of newborns is the leading cause of infant mortality in the United States. Its incidence, which has not decreased in the last twenty years, varies by ethnicity. Stress, anxiety, and depression are potential major factors in ethnic differences in preterm birth. Hispanics are one of the fastest growing ethnic groups in the US, having a pronounced increase in the preterm birth rate associated with length of stay in the US. At the same time there is a paucity of studies with biological components that examine the problem of prematurity and LBW in Hispanics. The overall purpose of this proposal is to test a biobehavioral model of causal pathways initiated by stress, cervical changes, and depression that may alter endocrine and immune factors leading to an inflammatory response, cervical changes, and ultimately LBW and preterm birth in Hispanics. The specific aims are to 1) determine the effects of stress, anxiety, and depression on endocrine and immune factors in Hispanic pregnant women that may lead to an inflammatory response and cervical changes resulting in alterations in gestational age at birth and birth weight, 2) assess the effects of stress, anxiety, and depression on health behaviors in pregnant Hispanic women that may impact endocrine and immune factors resulting in alterations in gestational age at birth and birth weight, and 3) ascertain the effects of demographic factors, social/cultural factors, and previous preterm birth on stress, anxiety, and depression in pregnant Hispanic women. In this prospective study pregnant women (n=508 minimum) will be recruited from two sites. Blood samples for assessment of levels of hormones, cytokines, and neopterin will be taken. Vaginal samples for assessment of levels of cytokines, neopterin, fetal fibronectin and bacterial vaginosis will also be obtained. Psychological questionnaires assessing stress, anxiety, and depression will be completed. Cervical length will be assessed by vaginal ultrasound. Medical record review for neonatal outcome data and an assessment of gestational age and birth weight will be completed after delivery on infants greater than 35 weeks. Data analysis will include structural equation modeling, multiple linear and logistic regression analysis, and correlation coefficient analysis. There is an urgent need to better understand the determinants of ethnic disparities as well as pathways involved in preterm birth. This study adopts a dynamic, biobehavioral approach that holds great promise in understanding the problem of preterm birth in Hispanic women. A clearer understanding of the interrelationships of the pathways leading to preterm birth and associated LBW is essential to determine and develop appropriate preventive strategies.

描述：（由申请人提供）与新生儿早产相关的低出生体重（LBW）是美国婴儿死亡的主要原因。其发病率在过去二十年里没有减少，因种族而异。压力、焦虑和抑郁是早产种族差异的潜在主要因素。西班牙裔是美国增长最快的族裔群体之一，其早产率显着增加，这与在美国停留的时间有关。与此同时，很少有针对西班牙裔早产和低出生体重问题的生物成分研究。该提案的总体目的是测试由压力、宫颈变化和抑郁引发的因果途径的生物行为模型，这些途径可能会改变内分泌和免疫因素，从而导致西班牙裔炎症反应、宫颈变化，并最终导致低出生体重和早产。具体目标是 1) 确定压力、焦虑和抑郁对西班牙裔孕妇内分泌和免疫因素的影响，这些因素可能导致炎症反应和宫颈变化，从而导致出生胎龄和出生体重的变化；2) 评估压力、焦虑和抑郁对西班牙裔孕妇健康行为的影响，这些因素可能影响内分泌和免疫因素，从而导致出生胎龄和出生体重的变化；3) 确定 人口因素、社会/文化因素和既往早产对西班牙裔孕妇压力、焦虑和抑郁的影响。在这项前瞻性研究中，将从两个地点招募孕妇（至少 508 名）。将采集血液样本以评估激素、细胞因子和新蝶呤的水平。还将获得阴道样本，用于评估细胞因子、新蝶呤、胎儿纤连蛋白和细菌性阴道病的水平。将完成评估压力、焦虑和抑郁的心理问卷。将通过阴道超声评估宫颈长度。新生儿结局数据的病历审查以及胎龄和出生体重的评估将在 35 周以上的婴儿分娩后完成。数据分析将包括结构方程建模、多元线性和逻辑回归分析以及相关系数分析。迫切需要更好地了解种族差异的决定因素以及早产的相关途径。这项研究采用了动态的生物行为方法，对于了解西班牙裔女性的早产问题大有希望。更清楚地了解导致早产和相关低体重的途径之间的相互关系对于确定和制定适当的预防策略至关重要。