The impact of a culturally-based live music intervention on the metabolites and metabolic pathways associated with chronic stress and the risk of preterm birth in Black women

基于文化的现场音乐干预对与慢性压力相关的代谢物和代谢途径的影响以及黑人女性早产风险

• 批准号: 10559006
• 负责人: Elizabeth Jeanne Corwin
• 金额: $ 73.53万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-16 至 2027-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10559006
• 关键词: 3-Dimensional; 37 weeks gestation; Academy; Address; Affect; Age; Baseline Surveys; Behavior; Bioinformatics; Biological; Biological Markers; Birth; Black race; Blinded; Chronic stress; Citric Acid Cycle; Clinic; Clinical; Clinical Trials; Control Groups; Corwin; Demographic Survey; Discipline of obstetrics; Discrimination; Disparity; Elements; Exposure to; First Pregnancy Trimester; Fundulus heteroclitus; Gestational Age; Glucocorticoids; Goals; Health; Health Disparities Research; Household; Human; Hydrocortisone; Individual; Infant; Inflammatory; Institute of Medicine (U.S.); Interdisciplinary Study; Intervention; Life Cycle Stages; Link; Mass Spectrum Analysis; Measures; Mediating; Medicine; Metabolic; Metabolic Pathway; Music; Music Therapy; National Institute on Minority Health and Health Disparities; Neighborhoods; Newborn Infant; Outcome; Oxidative Stress; Participant; Pathway Analysis; Patient Self-Report; Plasma; Population; Populations at Risk; Poverty; Pregnancy; Pregnancy Trimesters; Pregnant Women; Premature Birth; Production; Race; Randomized; Recording of previous events; Reporting; Research; Research Personnel; Resistance; Resolution; Risk; Risk Factors; Salivary; Sampling; Second Pregnancy Trimester; Socioeconomic Status; Stress; Surveys; System; Technology; Testing; Therapeutic; Therapeutic Intervention; Time; United States; Woman; adverse maternal outcomes; arm; black women; comparison intervention; cytokine; distraction; early experience; efficacy testing; experience; follow-up; food insecurity; group intervention; health disparity; health disparity populations; high risk; improved; improved outcome; infant outcome; innovation; intervention effect; low socioeconomic status; maternal stress; metabolic profile; metabolomics; myelination; neighborhood disadvantage; novel; perceived stress; pregnant; prenatal; racial disparity; recruit; saliva sample; sex; social health determinants; stem; stress reduction; stressor; tool; verbal

The health disparity in preterm birth (PTB) that exists in the United States (US) is a national crisis. Pregnant Black women have a 50% higher risk of PTB compared to pregnant White women in the US, and their infants are more than twice as likely to die. This disparity continues despite decades of research and tried intervention. Over ten years ago, the National Academy of Medicine identified Black women’s exposure to chronic stress as among the most important risk factors contributing to this health disparity and called for additional research as necessary. Although additional research has been conducted, the high rates of PTB among Black women have continued unabated. Thus, to address this significant critical need, we have brought together an exemplary team of researchers and clinicians with unique and complementary expertise. With this team, we will conduct a first of its kind clinic trial: testing the efficacy of a 10-week, live, culturally congruent music intervention compared to a similarly delivered 10-week sham control, to reduce the biological impact of chronic stress at the most fundamental level -- the molecules and metabolic pathways that are affected by stress. We further propose implementing the Music Characterization System (MCS) to identify the musical mechanisms underlying any benefit. Black women in the US often are exposed to chronic stress related to their race, sex, socioeconomic status, and social determinants of health including neighborhood and household food insecurity. Our study stems from our team’s previous research demonstrating that within a similar population of pregnant Black women, chronic stress was associated with changes in maternal metabolites and metabolic pathways linked to oxidative stress, energy production, and myelination, all potentially influencing pregnancy and newborn outcomes. This study also stems from our team’s rigorous research showing the power of live music to reduce stress and improve outcomes. Based on the National Institute of Minority Health and Health Disparities Research Framework, we will recruit 142 pregnant Black women during their 1st trimester of pregnancy and implement the Music Intervention or sham control beginning in the 2nd trimester. Women will collect saliva samples for later metabolomic analysis and complete surveys at the 1st, 5th, and 10th-week verbal or sham session. Birth outcomes will be determined from careful review of the labor and delivery record. Music is one of the earliest, most traditional art forms in human history, while metabolomics is one of the newest and most advanced technologies available in the world today. By combining the very old with the very new in this innovative study, we have the opportunity to identify a means by which the beneficial effects of live, culturally relevant music chosen by a pregnant woman and implemented therapeutically, can reduce the biological impact of the daily stressors to which she is exposed, and as a result, reduce one of the most persistent health disparities of our time, PTB.

美国早产（PTB）的健康差距是一个全国性的危机。怀孕 在美国，黑人妇女患PTB的风险比怀孕的白色妇女高50%， 婴儿死亡的可能性要高出一倍以上。尽管经过几十年的研究和尝试， 干预十多年前，美国国家医学院发现黑人妇女接触 慢性压力是造成这种健康差距的最重要的风险因素之一，并呼吁 必要时进行额外研究。虽然进行了额外的研究，但高PTB率 黑人妇女的情况有增无减。因此，为了满足这一重要的关键需求，我们 汇集了一个由研究人员和临床医生组成的具有独特和互补专业知识的模范团队。 与这个团队一起，我们将进行第一次此类临床试验：测试10周的有效性，活的，文化的， 一致的音乐干预相比，类似交付10周假对照，以减少 慢性应激的生物学影响在最基本的水平--分子和代谢途径 受到压力影响的人。我们进一步建议实施音乐表征系统， 找出任何好处背后的音乐机制。美国黑人女性经常接触到 与他们的种族、性别、社会经济地位和健康的社会决定因素有关的慢性压力， 邻里和家庭粮食不安全。我们的研究源于我们团队之前的研究 这表明在类似的黑人孕妇人群中，慢性压力与 母体代谢物和代谢途径的变化与氧化应激、能量产生和 髓鞘形成，所有这些都可能影响怀孕和新生儿的结果。这项研究也源于我们的 团队的严谨研究显示了现场音乐的力量，以减轻压力和改善结果。基于 国家少数民族健康和健康差异研究框架研究所，我们将招募142名 怀孕的黑人妇女在怀孕的第一个三个月，并实施音乐干预或假 从第二个三个月开始控制。妇女将收集唾液样本用于稍后的代谢组学分析， 在第1周、第5周和第10周的口头或假会话中完成调查。分娩结果将由 仔细查看了分娩记录音乐是中国最早、最传统的艺术形式之一， 代谢组学是人类历史上最新和最先进的技术之一， 当今世界通过在这项创新研究中将非常古老的与非常新的相结合，我们有机会 确定一种方法，使孕妇选择的现场文化相关音乐的有益效果 妇女和实施治疗，可以减少生物影响的日常压力，她 因此，减少了我们这个时代最持久的健康差距之一，PTB。