Biobehavioral Determinants of the Microbiome and Preterm Birth in Black Women

黑人女性微生物组和早产的生物行为决定因素

• 批准号: 8856370
• 负责人: Elizabeth Jeanne Corwin
• 金额: $ 50.65万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-28 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8856370
• 关键词: 25-hydroxyvitamin D; Address; Affect; African American; Age; Alcohol or Other Drugs use; Appointment; Area; Award; Bacterial Vaginosis; Behavior; Behavioral; Biological; Birth; Body mass index; Caucasians; Chronic stress; Clinical; Clinical Sciences; Communicable Diseases; Communities; Data; Discipline of obstetrics; Enrollment; Epidemiology; Epigenetic Process; Ethnic group; Event; Exposure to; Family; Fellowship; Folic Acid; Genetic; Genital system; Genitourinary system; Genomics; Glucocorticoids; Goals; Gynecology; Health; Health Status; Health behavior; Hematogenous Spread; Home environment; Hospitalization; Hospitals; Human Microbiome; Hydrocortisone; Hygiene; Individual; Infant; Infection; Inflammation; Inflammatory; Informatics; Institutes; Intake; Interdisciplinary Study; Intervention; Laboratories; Lactobacillus; Leadership; Life; Link; Longevity; Measures; Medical Records; Mental Depression; Microbe; Micronutrients; National Institute of Nursing Research; Nested Case-Control Study; Nurses; Nutritional; Nutritional status; Oral; Participant; Pattern; Perinatal Epidemiology; Periodontitis; Physiology; Polyunsaturated Fatty Acids; Population; Population Heterogeneity; Pregnancy; Premature Birth; Prenatal care; Probiotics; Race; Research; Research Design; Resistance; Risk; Risk Factors; Role; Sampling; Scientist; Self Care; Serum; Sexually Transmitted Diseases; Site; Socioeconomic Status; Source; Stress; Structure; Symptoms; Testing; Time; Training; Translational Research; United States; United States National Institutes of Health; Vagina; Variant; Woman; behavior influence; biobehavior; biopsychosocial; case control; clinically significant; cohort; cytokine; experience; improved; insight; low socioeconomic status; microbiome; nutrition; pregnant; prevent; psychosocial; rRNA Genes; racial and ethnic; racial difference; racial disparity; racism; reproductive; reproductive epidemiology; socioeconomics; stressor; success

DESCRIPTION (provided by applicant): The goals of this study are to elucidate the bio behavioral determinants that govern the structure and dynamics of the microbiome of African American (AA) women during pregnancy and to investigate whether microbiome composition is associated with PTB. The proposed study will contribute to a bio psychosocial understanding of within-race risk for PTB, providing insight into important risk and protective factors relevant to AA women who disproportionately experience PTB compared to any other US population. Our research is consistent with frameworks for eliminating racial disparities, which recognize the importance of studying potential risk factors within-race as a vital first step, and is congruent with the National Institute of Nursing Research goal of promoting and improving the health of individuals, families, and communities across the lifespan in a variety of clinical settings and within diverse populations. The study will prospectively enroll a socioeconomically diverse cohort of H 960 pregnant AA women and follow them through delivery, collecting data at three time points: twice via direct participant contact during prenatal care appointments (at 10-14 and 26-30 weeks' gestation), and once via review of the medical records from the delivery hospitalization. Using a nested case-control approach, we will designate as cases all women who experience PTB (an estimated 125 cases); an equal number of controls will be selected from among those who deliver a term infant. Using this study design we will: (1) Characterize the vaginal, oral, and gut microbiome during early and later pregnancy; (2) Examine whether bio behavioral factors linked with PTB - including biological indicators and experiences of stress, nutritional status, and health behaviors - influence the composition of the microbiome; (3) Determine whether the composition of the vaginal, oral, and gut microbiome in early and/or later pregnancy is associated with PTB; and (4) Investigate whether symptom patterns are associated with microbiomic milieu that increase the risk of PTB among AA women. The success of this research is supported by several factors. First, we have assembled a multidisciplinary collaboration of clinicians and basic and translational scientists representing expertise in infectious disease, obstetrics-gynecology, nutrition, genetics and epigenetics, stress physiology, epidemiology and informatics under the leadership of a nurse-scientist. Second, we have the support of the Atlanta Clinical and Translational Science Institute (CTSA award # NIH UL1TR000454); Emory's Interdisciplinary Training for Nurse Scientists Award (T32 NR012715), Emory's Reproductive and Perinatal Epidemiology Fellowship Award, and the Emory Integrated Genomics Core Laboratory. Third, Atlanta is home to AA women of broad SES, many of whom are served by Emory's affiliated delivery hospitals, enabling us to sample a diverse group of AA women, allowing for sufficient variation in the bio behavioral determinants under study to distinguish their independent and interactive effects on the microbiome and, ultimately, on the risk of PTB.

描述（由申请人提供）：本研究的目标是阐明在怀孕期间管理非裔美国人（AA）妇女微生物组的结构和动态的生物行为决定因素，并研究微生物组组成是否与PTB有关。拟议的研究将有助于对PTB的赛场内风险的生物心理社会理解，从而洞悉与其他美国人群相比，与AA妇女相关的AA妇女有关的重要风险和保护因素。我们的研究与消除种族差异的框架是一致的，这些框架认识到将潜在的危险因素内部研究作为至关重要的第一步的重要性，并且与国家护理研究所的目标是一致的，即促进和改善各种临床环境和多样化人群的个人，家庭和社区的健康和改善个人，家庭和社区的健康。这项研究将前瞻性地招募H 960孕妇妇女的社会经济多样性的队列，并通过交付，在三个时间点收集数据：两次通过预约产前护理期间的直接参与者接触（在10-14和26-30周的妊娠期），并一次通过从住院术中审查医疗记录。使用嵌套的病例对照方法，我们将指定为所有经历PTB的女性（估计125例）；在送达婴儿的人中，将选择相等数量的控件。使用此研究设计，我们将：（1）在早期和晚期怀孕期间表征阴道，口服和肠道微生物组； （2）检查与PTB相关的生物行为因素（包括生物学指标和压力，营养状况和健康行为）是否影响微生物组的组成； （3）确定阴道，口服和肠道微生物组在早期和/或更高的怀孕中是否与PTB有关； （4）研究症状模式是否与微生物环境相关，这会增加AA妇女中PTB的风险。这项研究的成功得到了几个因素的支持。首先，我们组建了临床医生以及代表传染病，妇产科，营养，遗传学和表观遗传学专业知识的基础和转化科学家的多学科合作。 在护士科学家的领导下，生理学，流行病学和信息学。其次，我们得到了亚特兰大临床和转化科学研究所（CTSA奖＃NIH UL1TR000454）的支持；埃默里（Emory）的护士科学家跨学科培训奖（T32 NR012715），埃默里（Emory）的生殖和围产期流行病学奖学金奖，以及埃默里（Emory）综合基因组核心实验室。第三，亚特兰大是AA妇女的所在地，其中许多人由埃默里（Emory）的关联送货医院提供服务，使我们能够采样一群多样化的AA妇女，从而使正在研究的生物行为行为决定因素有足够的差异，以区分其独立和互动性的对微生物组的独立和交互作用，并最终对PTB的风险进行最终的风险。