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Understanding the contributions of stress reactivity to racial disparities in adverse placental and pregnancy outcomes

了解应激反应对不良胎盘和妊娠结局的种族差异的影响

基本信息

批准号：
10636347
负责人：
William Adam Grobman
金额：
$ 73.2万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-04-19 至 2028-02-29
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10636347
关键词：
Affective Black race Blood Pressure Blood Vessels Cardiovascular Diseases Cardiovascular system Cells Child Chronic Disparity Ecological momentary assessment Education Environment Event Exposure to Face Frequencies Future Goals Health Health behavior Histologic Histology Hydrocortisone Hypertension Hypothalamic structure Immune system Income Individual Inequity Inflammation Laboratories Lesion Life Life Cycle Stages Measurement Measures Mediating Mothers Neighborhoods Neurosecretory Systems Not Hispanic or Latino Nulliparity Outcome Participant Physiological Pituitary Gland Placenta Play Population Pregnancy Pregnancy Outcome Pregnant Women Premature Birth Psychological Stress Reaction Reporting Research Resources Risk Salivary Severities Sex Discrimination Small for Gestational Age Infant Socioeconomic Status Stress Stress and Coping Stressful Event Testing Time Weather Woman adverse outcome adverse pregnancy outcome biological adaptation to stress black women black/white disparity cardiovascular disorder risk cardiovascular risk factor coping experience health inequalities heart rate variability immune function insight maternal stress mortality negative affect neonatal morbidity pregnancy disorder prenatal exposure prenatal stress psychologic racial difference racial discrimination racial disparity response social stressor stress reactivity stressor

项目摘要

ABSTRACT A growing number of studies has implicated maternal stress as an explanation for the higher burden of adverse pregnancy outcomes (APOs) seen among non-Hispanic Black women compared with their non-Hispanic White counterparts. Most studies that have explored the relationship between stress and APOs have focused solely on prenatal exposure to stressors, but Black women are generally exposed to more stressors over the life course than White women. Moreover, Black women may have more limited resources to cope with social stressors, as well as be more likely to experience enduring stressors like racial and/or gender discrimination, which may lead to dysregulated physiological and psychological responses to everyday stressors (i.e., stress reactivity). Several studies have shown dysregulated cardiovascular, neuroendocrine, and affective reactivity to stressors is associated with increased CVD risk and other adverse health outcomes in non-pregnant populations, but the impact of dysregulated stress reactivity on pregnancy outcomes remains poorly understood. Thus, the overall goal of this study is to examine the impact of physiological and psychological stress reactivity on adverse placental and pregnancy outcomes. We will use ecological momentary assessments and intensive measurements of heart rate variability, blood pressure, salivary cortisol, and positive and negative affect to generate personalized measures of how pregnant women respond to stressful experiences in their daily lives. We will then examine associations of these measures with adverse placental lesions and pregnancy outcomes. Finally, we will quantify the extent to which stress reactivity and exposure to stressors during pregnancy account for racial disparities in these adverse outcomes.

摘要越来越多的研究将母亲的压力作为不良负担加重的原因。非西班牙裔黑人女性与非西班牙裔白人女性的妊娠结局(APO)比较对口单位。大多数探讨压力和APO之间关系的研究都只专注于关于产前暴露于压力源，但黑人妇女通常在一生中暴露于更多的压力源当然比白人女性更重要。此外，黑人女性可能有更有限的资源来应对社会问题压力源，以及更有可能经历持久的压力源，如种族和/或性别歧视，这可能会导致对日常应激源(即压力)的生理和心理反应失调反应性)。一些研究表明，心血管、神经内分泌和情感反应性对应激源与非妊娠患者心血管疾病风险增加和其他不良健康后果相关人群中，但调节失调的应激反应对妊娠结局的影响仍然很小明白了。因此，这项研究的总体目标是检查生理和心理的影响应激反应对不良胎盘和妊娠结局的影响。我们将用生态瞬间评估和密集测量心率变异性、血压、唾液皮质醇和积极和消极的影响，以产生个性化的衡量孕妇如何应对压力他们在日常生活中的经历。然后我们将研究这些措施与不良胎盘的关系。损害和妊娠结局。最后，我们将量化压力反应性和暴露于孕期应激源是造成这些不良后果的种族差异的原因。