Social Stressors and Inflammation: A Mixed Methods Approach to Preterm Birth
社会压力源和炎症:早产的混合方法
基本信息
- 批准号:9469090
- 负责人:
- 金额:$ 76.49万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2017
- 资助国家:美国
- 起止时间:2017-01-06 至 2021-12-31
- 项目状态:已结题
- 来源:
- 关键词:37 weeks gestationAccountingAffectAfrican AmericanAnti-Inflammatory AgentsAnti-inflammatoryAnxietyAreaBiological MarkersBirthBirth RateBlood specimenC-reactive proteinCensusesChildChild MortalityChild health careChronic DiseaseChronic stressDataDevelopmentDevelopmental Delay DisordersEmotional StressEnrollmentEventGoalsHairHealthHealth Care CostsHormonesHospital RecordsHydrocortisoneIncidenceIndividualInfantInflammationInflammatoryInterleukin-10InterventionInterviewKnowledgeLeadLifeLinkLongitudinal StudiesMeasuresMediatingMedical RecordsMethodsMissionModelingModificationMorbidity - disease rateMotorNeighborhoodsNeonatal MortalityNot Hispanic or LatinoOutcomePathway interactionsPhysiologicalPlasmaPregnancyPregnancy OutcomePremature BirthPrenatal StructuresPsyche structureQuestionnairesRaceReportingResearchResourcesRiskSocial EnvironmentSocial supportStatistical Data InterpretationStressStructureTimeUnited States National Institutes of HealthWomanbaseclinical practicecohortcopingcytokinedepressive symptomsdesigneffective interventionhealth disparityhigh riskhigh risk populationhypothalamic-pituitary-adrenal axisimprovedimproved outcomeinsightlow socioeconomic statusmetropolitanneighborhood disadvantagephysical conditioningpregnantprematureprenatalprotective effectpsychological distresspsychosocialracial discriminationracial disparityresponsesocialstressor
项目摘要
African American women have 1.5 times the rates of preterm birth (PTB)(<37 weeks completed gestation)
compared with non-Hispanic white women. This disproportionately high PTB rate in African Americans is a
persistent health inequity that leads to high child mortality, morbidity, and developmental delays. In the U.S.
approximately $26 billion are spent annually on health care costs for infants and children that were born
prematurely. Recent attempts to explain the high PTB rates in African American women have focused on
social stressors, such as disadvantaged neighborhoods, racial discrimination, and stressful life events. These
social stressors may lead to PTB by increasing women's emotional stress levels. Not surprisingly, emotional
stress along with levels of the stress hormone cortisol and systemic inflammation - both physiological
responses to stress - have all been related to higher risk of PTB. In contrast, one's psychosocial resources
(e.g., social support) can lessen emotional stress and have protective effects on PTB.
Little is yet known about
the pathways by which social stressors affect inflammation, and ultimately PTB. The objective of the proposed
study is to determine how social stressors alter inflammation during pregnancy and lead to PTB in African
American women. We aim to: 1) determine the pathways by which social stressors affect PTB; and 2) describe
social stressors, emotional stress and psychosocial resources; the associations among these concepts; and
their impact on PTB from women's perspectives.
In this longitudinal convergent mixed methods design, we will enroll 1,500 African American women who live
in the Detroit metropolitan area. We will collect data on social stressors, emotional stress, and psychosocial
resources through questionnaires and administrative (e.g., census) data. This will be done three times
prenatally. At these same time points, levels of cortisol and systemic inflammation will be determined from hair
and blood samples, respectively. We will also obtain birth data from the prenatal and hospital records. In a
subsample of 60 women, semi-structured interviews will be conducted to more specifically understand the
associations among social stressors, emotional stress and psychosocial resources; and their impact on PTB.
We will conduct a variety of statistical, qualitative and mixed methods analyses using both quantitative and
qualitative data to determine answers to the aims of our study. We will also consider the timing of pregnancy in
our analyses, as the prenatal data are collected at three distinct time points. The proposed research is highly
relevant to NIH's mission to elucidate mechanisms underlying health disparities in PTB. Insights gained from
this mixed methods approach
may lead to the development of an individualized PTB risk profile based on a
woman's social stressors and biomarkers which will have potential use in clinical practice and be a target for
culturally appropriate
interventions to reduce PTB incidence in African American women, and will generate new
perspectives for future research in other racial groups through our detailed focus on this high risk group.
非裔美国妇女的早产率(PTB)是非裔美国妇女的1.5倍(妊娠期<37周)。
与非西班牙裔白色女性相比。非裔美国人中不成比例的高PTB率是一个
持续的健康不平等导致儿童死亡率高、发病率高和发育迟缓。在美国
每年大约花费260亿美元用于婴儿和出生儿童的医疗保健费用
过早地。最近试图解释非洲裔美国妇女的高PTB率集中在
社会压力源,如弱势社区、种族歧视和压力性生活事件。这些
社会压力可能会增加妇女的情绪压力,从而导致肺结核。毫不奇怪,情绪化
压力沿着压力激素皮质醇和全身炎症的水平--这两种生理
对压力的反应-都与PTB的高风险有关。相反,一个人的社会心理资源
(e.g.,社会支持)可以减轻情绪压力,对PTB有保护作用。
我们对
社会压力源影响炎症的途径,并最终影响PTB。建议的目标
一项研究旨在确定社会压力如何改变非洲人怀孕期间的炎症并导致PTB
美国女人我们的目标是:1)确定社会压力影响PTB的途径; 2)描述
社会压力源、情绪压力和心理社会资源;这些概念之间的联系;以及
从妇女的角度看其对PTB的影响。
在这个纵向融合的混合方法设计中,我们将招募1,500名非洲裔美国妇女,
在底特律都会区。我们将收集有关社会压力源、情绪压力和心理社会压力的数据。
通过问卷调查和行政(例如,人口普查)数据。这将进行三次
产前在这些相同的时间点,皮质醇和全身炎症的水平将确定从头发
和血液样本我们还将从产前和医院记录中获得出生数据。中
60名妇女的子样本,将进行半结构化访谈,以更具体地了解
社会压力源、情绪压力和社会心理资源之间的关系及其对肺结核的影响。
我们将进行各种统计,定性和混合方法的分析,使用定量和
定性数据,以确定我们的研究目标的答案。我们还将考虑怀孕的时间,
我们的分析,因为产前数据是在三个不同的时间点收集的。该研究建议高度
与NIH的使命相关,以阐明PTB中健康差异的潜在机制。从以下方面获得的见解:
这种混合方法
可能导致基于以下因素的个体化PTB风险特征的发展:
女性的社会压力源和生物标志物,这将在临床实践中有潜在的用途,并成为目标,
文化上适当
减少非裔美国妇女PTB发病率的干预措施,并将产生新的
通过我们对这一高风险群体的详细关注,展望未来在其他种族群体中的研究。
项目成果
期刊论文数量(0)
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会议论文数量(0)
专利数量(0)
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Carmen Giurgescu其他文献
Carmen Giurgescu的其他文献
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{{ truncateString('Carmen Giurgescu', 18)}}的其他基金
Epigenetic aging, social factors, and preterm birth among Black women
黑人女性的表观遗传衰老、社会因素和早产
- 批准号:
10605694 - 财政年份:2023
- 资助金额:
$ 76.49万 - 项目类别:
Social stressors and inflammation: A mixed methods approach to preterm birth
社会压力源和炎症:早产的混合方法
- 批准号:
10200235 - 财政年份:2017
- 资助金额:
$ 76.49万 - 项目类别:
Social stressors and inflammation: A mixed methods approach to preterm birth
社会压力源和炎症:早产的混合方法
- 批准号:
10091319 - 财政年份:2017
- 资助金额:
$ 76.49万 - 项目类别:
Social stressors and inflammation: A mixed methods approach to preterm birth
社会压力源和炎症:早产的混合方法
- 批准号:
10176636 - 财政年份:2017
- 资助金额:
$ 76.49万 - 项目类别:
Social stressors and inflammation: A mixed methods approach to preterm birth
社会压力源和炎症:早产的混合方法
- 批准号:
10076266 - 财政年份:2017
- 资助金额:
$ 76.49万 - 项目类别:
Race Related Stressors and Preterm Birth in African American Women
非洲裔美国女性的种族相关压力源和早产
- 批准号:
7693848 - 财政年份:2008
- 资助金额:
$ 76.49万 - 项目类别:
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