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

美国存在的早产(PTB)健康差距是一种全国性的危机。怀孕了 在美国，黑人女性患肺结核的风险比怀孕的白人女性高50%，而且她们 婴儿死亡的可能性是前者的两倍以上。尽管经过几十年的研究和尝试，这种差距仍在继续 干预。十多年前，美国国家医学研究院发现，黑人女性暴露在 长期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 必要时进行额外的研究。尽管已经进行了更多的研究，但肺结核的高发病率 在黑人女性中的比例继续有增无减。因此，为了满足这一重要的关键需求，我们有 汇集了一支具有独特和互补专业知识的模范研究人员和临床医生团队。 在这个团队的帮助下，我们将进行首个此类临床试验：测试为期10周的活的、文化上的 一致的音乐干预与类似交付的10周假控制相比，以减少 慢性应激在最基本水平上的生物影响--分子和代谢途径 会受到压力的影响。我们进一步建议实施音乐特写系统(MCS)以 找出任何益处背后的音乐机制。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，包括 邻里和家庭的粮食不安全。我们的研究源于我们团队之前的研究 研究表明，在类似的黑人怀孕女性群体中，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局。这项研究也源于我们的 团队的严谨研究显示了现场音乐在减轻压力和改善结果方面的力量。基于 国家少数民族健康与健康差距研究所框架，我们将招聘142人 怀孕前三个月的黑人孕妇并实施音乐干预或伪装 从第二个三个月开始控制。女性将收集唾液样本，用于稍后的代谢分析和 在第一周、第五周和第十周的口头或虚假会议上完成调查。出生结果将被确定 仔细审查分娩记录和分娩记录。音乐是世界上最早、最传统的艺术形式之一 人类历史，而代谢组学是世界上最新和最先进的技术之一 当今世界。在这项创新的研究中，通过将非常古老和非常新的东西结合起来，我们有机会 确定一种方式，通过这种方式，孕妇选择具有文化相关性的现场音乐的好处 女性并通过治疗实施，可以减少日常应激源对她的生物影响 因此，减少了我们这个时代最持久的健康差距之一--肺结核。

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.