Mechanisms for Preterm Birth in African-American Women

非裔美国女性早产的机制

• 批准号: 6673707
• 负责人: SUSAN GENNARO
• 金额: $ 7.93万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-08-15 至 2005-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6673707
• 关键词: African American; chlamydial disease; clinical research; corticotropin releasing factor; disease /disorder etiology; disease /disorder proneness /risk; epidemiology; female; health behavior; human pregnant subject; human subject; mother /embryo /fetus nutrition; pathologic process; pregnancy disorder; pregnancy infection; premature infant human; premature labor; reproductive system infection; stress

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.

描述（由申请人提供）：在全国范围内，每年有11%的孕妇经历自发性早产，但只有40-50%的早产儿以早产结束。早产的机制仍然知之甚少，特别是在非洲裔美国妇女，特别是在早期早产（妊娠34周之前）。在我们早期的联邦资助的研究中，早产儿的母亲在分娩时、产后1、2和4个月的免疫功能明显低于足月儿的母亲（对刀豆球蛋白A、美洲商陆有丝分裂原和植物血凝素的反应是淋巴细胞增殖减少）。然而，目前尚不清楚这种改变的免疫反应是否存在于早产之前。 感染也被认为是早产的一个致病因素，我们的一个研究小组最近的工作将宫颈阴道细胞因子的增加与非妊娠妇女的阴道感染联系起来，强调了检查局部和全身细胞免疫反应与出生结果之间关系的必要性。 这项研究将比较压力（感知压力，CRH），感染（衣原体，淋病，细菌性阴道病），健康行为（吸烟、营养）和免疫反应（宫颈阴道和血清IL-1，IL-6和TNF-α）之间的三组非洲裔美国妇女：20例正常妊娠和足月分娩，20例妊娠24-34周的早产妇女足月分娩，20例妊娠24-34周的早产妇女在妊娠34周前分娩。这项研究将为我们提供必要的初步数据，以支持重大资助申请，使我们能够标准化实验室程序，并通过提供血清，宫颈和阴道细胞因子水平之间相关性的数据来告知更大研究的方法。它还将提供初步数据，以确定那些最能区分经历早产但足月分娩的非洲裔美国妇女与那些经历早产和早产的非洲裔美国妇女的因素。