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Psychoneuroimmunology: Preterm birth in Hispanics

心理神经免疫学：西班牙裔早产

基本信息

批准号：
8593415
负责人：
Roberta Jeanne Ruiz
金额：
$ 12.13万
依托单位：
OHIO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2002
资助国家：
美国
起止时间：
2002-07-01 至 2013-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8593415
关键词：
Psychoneuroimmunology Preterm birth Hispanics

项目摘要

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民族，具有高生育率和高早产率（PTB）的潜力。如果肺结核发病率继续上升，将对儿童造成毁灭性的影响，并增加医疗费用。在R01 NR00789-04的更新申请中，我们提出澄清西班牙裔妇女的文化适应对PTB的影响，并评估社会心理、生理和遗传介导因素在文化适应与生育结局之间的关系中的作用。当个人接受另一种文化的态度、价值观、习俗、信仰和行为时，文化适应就发生了。先前的研究显示了一个拉美裔悖论，即相对而言，不太适应文化的拉美裔人拥有完整的社会关系，尽管他们的社会经济地位较低，但他们的健康状况比预期的要好。我们目前的研究支持这一观点，并表明适应文化程度较高的妇女早产率为13.4%，而适应文化程度较低的妇女患肺结核的比率仅为4.7%。压力导致的炎症因子在我们这个文化适应程度更高的群体中更高，这可能会增加患肺结核的风险。有了新的资金，我们将通过研究怀孕22-24周的西班牙裔孕妇来检验这些结果。目的1：确定哪些适应因素可以预测与肺结核和LBW相关的免疫和内分泌反应。目标2：确定异文化逆境的哪些组成部分介导了异文化因素对预测PTB和LBW的免疫和内分泌反应的贡献。目标3：确定社会心理保护因素的哪些组成部分介导了适应因素对预测肺结核和LBW的免疫和内分泌反应的贡献。目的4：鉴定可能影响TNF-1和IL-1Ra并介导应激反应的促炎细胞因子基因多态性。这项前瞻性观察性研究将重点关注500名年龄在14-45岁的西班牙裔女性，单次宫内妊娠。我们将：1)使用自我报告工具来评估异文化困扰和心理社会保护因素；2)多维度测量文化适应；3)测量血液中多种应激和生殖激素、炎症细胞因子及其基因多态性；4)通过审查医疗记录来评估母婴结局；5)通过逻辑回归和/或结构方程模型分析数据。我们将学习适应如何影响生物反应。我们计划利用社会心理和生物风险数据，对那些风险最大的妇女进行重点干预。公共卫生相关性：这一更新的目的是澄清西班牙裔妇女文化适应对早产的影响，使用文化适应的多维测量和评估中介因素在解释文化适应与出生结果之间关系中的作用。我们还将研究我们目前的证据是否表明，随着文化适应（英语水平）的提高，炎症的增加与炎症反应的遗传易感性（即增加早产的风险）不同。我们对文化适应和早产之间关系的理解在实施干预措施以促进健康的母婴结局的过程中至关重要。

项目成果

期刊论文数量（15）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Network Structure of Perinatal Depressive Symptoms in Latinas: Relationship to Stress and Reproductive Biomarkers.

DOI：
10.1002/nur.21784
发表时间：
2017-06
期刊：
Research in nursing & health
影响因子：
2
作者：
Santos H Jr;Fried EI;Asafu-Adjei J;Ruiz RJ
通讯作者：
Ruiz RJ

Measuring coping in pregnant minority women.

DOI：
10.1177/0193945914527176
发表时间：
2015-02
期刊：
Western journal of nursing research
影响因子：
1.8
作者：
Ruiz RJ;Gennaro S;O'Connor C;Marti CN;Lulloff A;Keshinover T;Gibeau A;Melnyk B
通讯作者：
Melnyk B

Pregnant Mexican American Biopsychosocial/Cultural risks for adverse infant outcomes.