Intra- and Intergenerational Consequences of Maternal Stress Exposure for Maternal-Infant Health in Black U.S. Families

项目总结 在美国，黑人母亲和婴儿与怀孕相关的情况不成比例地恶化 健康结果。黑人母亲在出生一年内死亡的可能性是普通人的1.5-4倍 与非黑人母亲相比，黑人婴儿死亡的可能性是非黑人母亲的2-3倍 非黑人婴儿。这些上升的比率进一步与产科比率的上升联系在一起 母亲的心血管并发症，以及早产和婴儿的低出生体重。这个 造成这些差异的原因尚不清楚，但迄今的证据表明，它们很可能是 具有社会性和环境性。因此，迫切需要确定以下决定因素： 这些种族差异，以阐明干预的最优先目标。建议数 研究将评估微观(例如，人际、家庭)和宏观层面(例如， 邻居、环境)风险和恢复力因素影响母婴 健康。此外，这项研究还询问了心理生物学机制。 它们之间的联系(即，生理应激失调，如唾液皮质醇， 呼吸性窦性心律不齐、皮肤电活动)。具体目标是：(1)确定 母亲暴露在多水平应激源下的代内和代际健康后果 以及在怀孕期间和整个生命过程中的弹性因素，(2)评估 母婴应激生理学在塑造母婴健康中的机制作用 (3)估计父亲的支持在多大程度上促进母婴健康 在怀孕期间和产后。为了实现这些目标，这一预期的纵向 这项研究将跟踪350个黑人家庭(母亲、父亲、婴儿)从怀孕到第一个 产后一年，在怀孕期间和婴儿6个月和12个月时进行家访。这 研究采用了多种方法，并借鉴了自我报告、心理生理学 评估、行为观察、病历提取和空间分析 地理信息系统(GIS)。此外，这项研究强调风险(例如， 人际和结构性种族主义)和复原力(例如，种族认同、文化信仰和 价值观)对美国黑人特别相关的因素。这样做的长期目标是 研究旨在确定促进美国黑人几代人健康的目标。 家人。

PROJECT SUMMARY In the US, Black mothers and infants experience disproportionately worse pregnancy-related health outcomes. Black mothers are 1.5-4 times more likely to die within a year of birth compared to non-Black mothers, and Black infants are 2-3 times more likely to die compared to non-Black infants. These elevated rates have further been tied to elevated rates of obstetric cardiovascular complications for mothers, and preterm birth and low birthweight for infants. The causes for these disparities are unknown, but evidence to date suggests that they are likely social and environmental in nature. Thus, there is an urgent need to identify the determinants of these racial disparities to elucidate the highest priority targets for intervention. The proposed research will evaluate how micro- (e.g., interpersonal, family) and macro-level (e.g., neighborhood, environmental) risk and resiliency factors transact to shape maternal-infant health. Additionally, this research interrogates the psychobiological mechanisms that underlie their associations (i.e., physiological stress dysregulation, as indexed by i.e., salivary cortisol, respiratory sinus arrhythmia, electrodermal activity). Specific aims are to: (1) determine the intra- and intergenerational health consequences of maternal exposure to multi-level stressors and resiliency factors both during pregnancy and across her life course, (2) evaluate the mechanistic role of maternal and infant stress physiology in shaping maternal-infant health, and (3) estimate the extent to which paternal support may promote maternal-infant health both during pregnancy and the postpartum. To achieve these aims, this prospective longitudinal study will follow 350 Black families (mothers, fathers, infants) from pregnancy through the first postpartum year, with home visits during pregnancy, and at infant ages 6 and 12 months. This research utilizes a multi-method approach, and draws from self-report, psychophysiological assessment, behavioral observations, medical record abstraction, and spatial analyses using Geographic Information Systems (GIS). Additionally, this research emphasizes risk (e.g., interpersonal and structural racism) and resiliency (e.g., racial identity, cultural beliefs and values) factors of particular relevance for Black Americans. The long-term objective of this research is to identify targets through which to promote health in generations of Black U.S. families.