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

项目总结

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.