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

项目摘要 在美国，黑人母亲和婴儿经历了不成比例的更糟糕的怀孕相关的 健康成果。黑人母亲在出生后一年内死亡的可能性高出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死亡率的上升有关。 母亲的心血管并发症以及婴儿的早产和低出生体重。的 这些差异的原因尚不清楚，但迄今为止的证据表明，它们很可能是 社会和环境方面。因此，迫切需要确定 这些种族差异，以阐明干预的最高优先目标。拟议 研究将评估微（例如，人际、家庭）和宏观层面（例如， 邻里，环境）风险和弹性因素的作用，以塑造母婴 健康此外，这项研究还探讨了 它们的关联（即，生理应激失调，如指数所示，即，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 母亲受到多层次压力因素的影响对代内和代间健康的影响 和弹性因素在怀孕期间和整个生命过程中，（2）评估 母婴应激生理学在塑造母婴健康方面的机械作用，以及 (3)估计父亲的支持在多大程度上可以促进母婴健康 在怀孕和产后期间。为了实现这些目标，本前瞻性纵向 这项研究将跟踪350个黑人家庭（母亲、父亲、婴儿），从怀孕到第一次怀孕。 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 研究采用多种方法，并从自我报告，心理生理学， 评估、行为观察、医疗记录抽象和空间分析 地理信息系统。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 这些因素与美国黑人特别相关。长期目标是 研究的目的是确定通过哪些目标，以促进健康的几代美国黑人。 家庭

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.