Psychoneuroimmunology: Preterm birth in Hispanics

心理神经免疫学：西班牙裔早产

• 批准号: 8056087
• 负责人: Roberta Jeanne Ruiz
• 金额: $ 29.68万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 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 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8056087
• 关键词: Acculturation; Adopted; Affect; African American; Age; Assimilations; Attitude; Beck depression inventory; Behavior; Behavioral; Belief; Biological; Biological Markers; Birth; Birth Rate; Birth Weight; Blood; Categories; Child; Complex; Corticotropin; Corticotropin-Releasing Hormone; Custom; Cytokine Gene; Data; Data Analyses; Dimensions; Discrimination; Distress; Endocrine; Epidemiologic Studies; Equation; Equilibrium; Equipment and supply inventories; Estriol; Evaluation; Exhibits; Face; Family; Fertility Rates; Funding; Genes; Genetic; Genetic Polymorphism; Genetic Predisposition to Disease; Grant; Health; Hispanics; Hormones; Hydrocortisone; Immune; Immune response; Individual; Inflammation; Inflammatory; Inflammatory Response; Institutional Review Boards; Interleukin-1; Interleukins; Intervention; Language; Learning; Length; Life; Logistic Regressions; Measures; Mediating; Medical; Medical Records; Mental Depression; Methods; Mexican Americans; Modeling; NIH Program Announcements; Observational Study; Outcome; Outcomes Research; Patient Self-Report; Physiological; Population; Pregnancy; Pregnant Women; Premature Birth; Prevalence; Process; Progesterone; Progress Reports; Psychoneuroimmunology; Relative (related person); Risk; Role; Sample Size; Sampling; Social support; Stress; TNF gene; Tumor Necrosis Factor-alpha; Woman; biological adaptation to stress; cohesion; coping; cost; cytokine; depressive symptoms; effective intervention; ethnic minority population; experience; fetal; follow-up; high risk; improved; infant outcome; instrument; low socioeconomic status; peripheral blood; pregnant; premature; prospective; psychosocial; reproductive hormone; response; self esteem; social

DESCRIPTION (provided by applicant): The Hispanic population, the fastest growing ethnic minority in the US, has a high fertility rate and the potential for a high rate of preterm births (PTB). If the PTB rate continues to rise, it will have devastating effects on children and increase medical costs. In this renewal application of R01 NR00789-04, we propose to clarify the impact of acculturation of Hispanic women on PTB, and to assess the roles of psychosocial, physiologic, and genetic mediating factors in the relationships between acculturation and birth outcomes. Acculturation occurs as individuals adopt the attitudes, values, customs, beliefs and behaviors of another culture. Previous studies show a Hispanic Paradox in which relatively less acculturated Hispanics with intact social relationships exhibit better than expected health outcomes, despite low socio- economic status. Our current study supports this and indicates a preterm birth rate of 13.4 percent for the more acculturated women as compared to a PTB rate of only 4.7 percent for the less acculturated women. Inflammatory factors resulting from stress are higher in our more acculturated group, potentially increasing the risk of PTB. With renewed funding, we will examine these results by studying Hispanic pregnant women at 22-24 weeks gestation. Aim 1: Identify which acculturation factors predict immune and endocrine responses that are associated with PTB and LBW. Aim 2: Identify which components of acculturative distress mediate the contribution of acculturation factors on the immune and endocrine responses that predict PTB and LBW. Aim 3: Identify which components of the psychosocial protective factors mediate the contribution of acculturation factors to immune and endocrine responses that predict PTB and LBW. Aim 4: Identify pro-inflammatory cytokine gene polymorphisms that may affect TNF-1 and IL-1Ra and may mediate stress responses. This prospective, observational study will focus on 500 Hispanic women, ages 14-45 years, with a single intrauterine pregnancy. We will: 1) use self-report instruments to assess acculturative distress and psychosocial protective factors; 2) measure acculturation in a multi-dimensional way; 3) measure numerous stress and reproductive hormones, and inflammatory cytokines in the blood and their gene polymorphisms; 4) assess maternal and infant outcomes through a review of medical records; 5) analyze data through logistic regression and/or structural equation modeling. We will learn how acculturation affects biological responses. We plan to use psychosocial and biological risk data to focus interventions for those women most at risk. PUBLIC HEALTH RELEVANCE: The purpose of this renewal is to clarify the impact of acculturation of Hispanic women on preterm birth, using a multidimensional measure of acculturation and assessing the role of mediating factors in explaining the relationships between acculturation and birth outcomes. We will also examine whether our current evidence related to increased inflammation with more acculturation (English proficiency) is different by genetic predisposition of the inflammatory response (i.e. increasing the risk of preterm birth). Our understanding of the relation between acculturation and prematurity is vital in the process of implementing interventions to promote a healthy maternal and fetal outcome.

描述（由申请人提供）：西班牙裔人口是美国增长最快的少数族裔，其生育率很高，并且有可能获得高早产率（PTB）的潜力。如果PTB率继续上升，它将对儿童产生毁灭性的影响并增加医疗费用。在R01 NR00789-04的这种续签应用中，我们建议澄清西班牙裔妇女对PTB的适应性影响，并评估心理社会，生理和遗传介导因子在研究与出生和出生表现之间的关系中的作用。适应发生时，个人采用了另一种文化的态度，价值观，习俗，信念和行为。先前的研究表明，西班牙裔悖论，尽管社会经济状况较低，但与预期的社会关系完整的社会关系相对较少的社会关系表现更好。我们目前的研究支持这一点，并表明较培养的女性的早产13.4％，而较少的妇女的PTB率仅为4.7％。在我们的培养群体中，由压力引起的炎症因素较高，可能会增加PTB的风险。通过续签资金，我们将通过在妊娠22-24周研究西班牙裔孕妇来检查这些结果。目标1：确定哪些适应因素可以预测与PTB和LBW相关的免疫和内分泌反应。目标2：确定哪些适应性困扰的组成部分介导了适应因素对预测PTB和LBW的免疫和内分泌反应的贡献。目标3：确定哪些社会心理保护因素的组成部分介导了预测PTB和LBW的免疫和内分泌反应的培养因素的贡献。目标4：确定可能影响TNF-1和IL-1RA的促炎性细胞因子基因多态性，并可能介导胁迫反应。这项前瞻性的观察性研究将重点关注500名14-45岁的西班牙裔妇女，宫内妊娠一次。我们将：1）使用自我报告工具来评估文化上的困扰和社会心理保护因素； 2）以多维方式衡量适应； 3）测量血液及其基因多态性中的许多应力和生殖激素以及炎症细胞因子； 4）通过审查病历来评估母亲和婴儿的结果； 5）通过逻辑回归和/或结构方程建模来分析数据。我们将学习适应如何影响生物学反应。我们计划使用社会心理和生物学风险数据来为这些女性最大的干预措施集中干预措施。 公共卫生相关性：这种更新的目的是阐明西班牙裔妇女对早产的适应影响，使用多维衡量适应性的衡量，并评估中介因素在解释适应和出生结果之间的关系中的作用。我们还将检查我们目前与炎症增加有关的证据（英语能力）是否因炎症反应的遗传倾向而有所不同（即增加早产的风险）。我们对适应和早产之间关系的理解对于实施干预措施以促进健康的母亲和胎儿结果至关重要。