Bio-Psych Stress Measure Associations and Preterm Birth

描述(由申请人提供)：有令人信服的证据表明，慢性压力会增加早产的风险。一种被认为的机制是通过母体-胎儿-胎盘-下丘脑-垂体-肾上腺轴，促肾上腺皮质激素释放激素(CRH)发挥主要调节作用。这项针对100名孕妇的初步研究有三个目的：1)使用慢性压力的心理、行为和人口统计指标，确定孕妇慢性压力的哪些方面与妊娠15-20周的CRH水平最强和最具预测性；2)确定这些慢性压力测量方法的差异，以及妊娠15-20周CRH水平的分类分裂(即四分位数、三分位数)之间的差异，以确定是否有相关群体有潜力进行压力缓解干预；以及3)评估CRH测量方法与妊娠15-20周慢性应激之间的关系。以及足月与早产的结局，以确定哪些指标可能具有最大的预测价值。这项初步研究将为未来可能减少早产的减压干预措施的研究奠定基础。这项研究将与一个纵向的孕妇血清样本收集和存储项目一起进行，该项目将供申请者用于未来的生物行为研究。

DESCRIPTION (provided by applicant): There is compelling evidence that chronic stress contributes to the risk of preterm birth. A proposed mechanism for this contribution is via the maternal-fetal-placental hypothalamic-pituitary-adrenal axes, with corticotropin-releasing hormone (CRH) playing a major regulatory role. The proposed preliminary study of 100 pregnant women has three aims: 1) To identify which aspects of maternal chronic stress have the strongest and most predictive relationships with CRH levels at 15-20 weeks of gestation, using psychometric, behavioral, and demographic indicators of chronic stress, 2) To identify differences in these measures of chronic stress, between categorical splits (i.e. quartiles, tertiles) in CRH levels at 15-20 weeks of gestation, in order to determine if there are relevant groups having potential for stress reduction interventions, and 3) To evaluate the relationships between measures of CRH and chronic stress at 15-20 weeks gestation, and the outcome of term vs. preterm birth, in order to determine which measures might render the greatest predictive value. This preliminary study will lay the groundwork for future investigations of stress reduction interventions having potential to reduce preterm birth. The study will be conducted in conjunction with a longitudinal maternal serum sample collection and storage project, which will be available to the applicant for future biobehavioral research studies.