Mechanisms for Preterm Birth in African-American Women

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DESCRIPTION (provided by applicant): Nationally, 11% of pregnant women experience a spontaneous preterm delivery every year but only 40-50% of preterm labors end in preterm delivery. The mechanism for preterm delivery remains poorly understood especially among African-American women and especially in early preterm labor (prior to 34 weeks gestation). In our earlier federally funded work, mothers of preterm infants compared to mothers of term infants had significantly poorer immune function (diminished lymphocyteproliferation in response to concanavalin A, pokeweed mitogen, and phytohemagglutinin) at delivery, and 1, 2 and 4 months postpartum. However, it is not known if this altered immune response was present prior to preterm delivery. Infection is also purported to be a causative factor in preterm birth and recent work by one of our research team linking increases in cervicovaginal cytokines with vaginal infections in non pregnant women underscores the need to examine the relationship between local and systemic cellular immune response to birth outcomes. This study will compare stress (perception of stress, CRH), infection (chlamydia, gonorrhea, bacterial vaginosis), health behaviors (smoking, nutrition) and immune response (cervicovaginal and serum IL-1, IL-6 and TNF-alpha) between three groups of African-American women: 20 experiencing a normal pregnancy and term delivery, 20 women presenting between 24-34 weeks of gestation in preterm labor delivering at term and 20 women presenting between 24-34 weeks of gestation in preterm labor who deliver before 34 weeks gestation. The study will provide us with necessary preliminary data to support a major grant submission, allow us to standardize laboratory procedures and inform the methodology of the larger study by providing data on the correlation between serum, cervical, and vaginal cytokine levels. It will also provide preliminary data to identify those factors that best differentiate African American women who experience preterm labor but deliver at term from those who deliver experience preterm labor and deliver prematurely from those who never labor prematurely and who deliver at term.