Psychoneuroimmunology: Preterm Birth in Hispanics

拉美裔是美国规模最大、增长最快的种族群体，其早产率 随着文化适应而增加。我们已经描绘了一条从文化适应到 拉美裔婴儿出生体重和胎龄下降与内分泌和免疫系统的关系 女人。我们正在为#7RoiNRoy89-O4的竞争续订添加以下步骤，以(A)发现 文化适应对胎龄和出生体重的多维直接和间接影响(B)阐明 (通过连续测量)该途径发生在怀孕早期的时期，(C)确定基因 易感性(细胞因子多态)的途径的免疫成分，和(D)发展 并检验其在从文化适应到胎龄的路径与胎龄之间的中介作用 出生体重。目的：探讨文化适应(多维测量)对儿童心理健康的影响。 影响内分泌和免疫的情绪困扰、健康行为和心理保护因素 预测胎龄和出生体重下降的反应。目标2：确定产前是否 孕周减少和出生体重减少的内分泌和免疫预测因子存在于 怀孕的西班牙裔妇女早在15-17周。目的3：鉴定炎性细胞因子基因 拉美裔孕妇产生IL-1O、TNF-α、IL-6和IL-1ra的基因多态性 女人。目的4：测试一个将文化适应的组成部分与情绪困扰指标联系起来的模型， 健康行为、心理保护因素和变态负荷(内分泌和免疫因素) 预测胎龄下降和出生体重下降。 该设计是前瞻性的，具有观察性，重点是14-45岁的西班牙裔女性 样本大小为500名妇女的宫内妊娠。许多自我报告工具将评估 情绪困扰和心理社会保护因素。文化适应将由多个维度来衡量 接近。我们将通过饮食记录和非法药物以及尿液中的吸烟来衡量营养素的摄入量。我们会 检测血液中多种应激激素、生殖激素和炎性细胞因子，以及它们的 基因多态。我们将对母婴结局进行病历审查。对于AIM I，我们 将使用因子分析的文化适应领域和结构方程模型(SEM)的 文化适应的调停者。对于目标2，我们将使用扫描电子显微镜观察妊娠15-17周，并与模型进行比较 22-24周。我们将使用X2、线性和Logistic回归对目标3进行分析。对于目标4，我们将测试 使用内部一致性测量的不平衡负荷(AL)评分的信度和效度，然后是因子 分析。文化适应作为一个潜在变量将被用在扫描电子显微镜的AL评分中。我们将添加调解 变量进入扫描电子显微镜，比较模型在15-17周和22-24周的相关情况。

Hispanics are the largest and fastest growing ethnic group in the US with the rates of preterm birth increasing with acculturation. We have delineated a predictive pathway from acculturation through the endocrine and immune systems to decreased infant birth weight and decreased gestational age in Hispanic women. We are adding in the next steps for this competitive renewal of #7RoiNRooy89-O4 to (a) discover multidimensional direct and indirect effects of acculturation on gestational age and birth weight (b) elucidate periods (by serial measurements) for when the pathway occurs early in pregnancy, (c) identify the genetic predisposition (cytokine polymorphisms) for the immune component of the pathway, and (d) develop an allostatic load score and test its mediating effect between the path from acculturation to gestational age and birth weight. Aim l: To identify the effects of acculturation (using a multidimensional measurement) on emotional distress, health behaviors, and psychological protective factors affecting endocrine and immune responses which predict decreases in gestational age and birth weight. Aim 2: To identify whether antenatal endocrine and immune predictors of decreased gestational age and decreased birth weight are present in pregnant Hispanic women as early as 15-17 weeks. Aim 3: To identify inflammatory cytokine gene polymorphisms responsible for IL-1O, TNF-a, IL-6, and IL-i Ra production in pregnant women Hispanic women. Aim 4: To test a model linking components of acculturation with indicators of emotional distress, health behaviors, psychological protective factors and allostatic load (endocrine and immune factors) predicting decreased gestational age and decreased birth weight. The design is prospective, and observational, focusing on Hispanic women ages 14-45 with a single intrauterine pregnancy with a sample size of 500 women. Numerous self-report instruments will assess emotional distress and psychosocial protective factors. Acculturation will be measured by a multidimensional approach. We will measure nutrient intake by diet record and illicit drugs and smoking in the urine. We will measure in the blood numerous stress and reproductive hormones and inflammatory cytokines, and their gene polymorphisms. We will do a medical record review for maternal and infant outcomes. For aim i, we will use factor analysis of the domains of acculturation and Structural Equation Modeling (SEM) of the mediators of acculturation. For aim 2, we will use SEM for 15-17 weeks gestation and compare to the model at 22-24 weeks. We will analyze Aim 3 using X2, linear and logistic regression. For Aim 4, we will test the reliability and validity of the allostatic load (AL) score using internal consistency measures, and then factor analysis. Acculturation as a latent variable will be used with the AL score in SEM. We will add the mediating variables into the SEM and compare the model at 15-17 weeks and 22-24 weeks, concerned.