- February 5, 2014

Science Daily/Ohio State University Center for Clinical and Translational Science

African American women today are almost twice as likely to deliver a preterm baby as white, Hispanic or Asian women in the US - a disparity that medical conditions, socioeconomic status, access to prenatal care and health behaviors haven’t been able to fully account for.

Two new studies explore the complex relationship between race, stress and inflammation and potential impacts on pregnancy in the hope of reducing preterm births and infant mortality, and improving maternal mental health.

Each year, a half million babies in the United States are born too early, causing complications that make prematurity the number one cause of infant death in the country. African American women are almost two times more likely to deliver a preterm baby than women of other races, a disparity that is not been fully explained by socioeconomic status, access to healthcare, or health behaviors.

Now, by exploring the complex associations between race, stress, inflammation and pregnancy, researchers at The Ohio State University Wexner Medical Center have uncovered biological and behavioral clues that could help lead to new interventions and ideas for reducing premature births.

"Psychological stress, including the stress of racial discrimination, has been associated with risk for preterm birth in many studies. However, we know little about the biological mechanisms that may contribute to this increased risk," said lead author Lisa Christian, PhD, an assistant professor of Psychiatry and the Institute for Behavioral Medicine Research (IBMR) at Ohio State.

"Prior studies suggest that, during healthy pregnancy, cardiovascular and neuroendocrine responses to stress are dampened. This study examined whether this dampening also occurs in relation to stress-induced inflammation. And, if so, do African American women show such dampening to the same extent as white women."

Race, acute stress trigger exaggerated inflammatory response

In a study of white and African American women, both pregnant and non-pregnant, Christian's team found that African American women showed stronger inflammatory response to acute psychological stress.

"Statistically, African-Americans have a higher incidence of chronic illnesses such as heart disease and diabetes. If women are comparing themselves to others in their community who have serious illnesses, then they may think that they are doing pretty good in comparison," said Christian. "Understanding this point of view gives clinicians opportunities to probe a little more during prenatal visits."

Christian notes that more research is needed to better understand the complex relationship between such diverse factors like inflammation, race and pregnancy, but says that her research has a very basic message about maternal mental health that applies to all women.

"Women who are very conscientious about their health behaviors, such as taking prenatal vitamins and avoiding alcohol, may not take the same time to focus on their emotional well-being," said Christian.

"I would tell an expecting mother to work with her doctors to proactively address life stressors. That way she can not only enjoy her pregnancy and prepare for the new baby, but she may ultimately improve her pregnancy outcomes and help her developing baby."

http://www.sciencedaily.com/releases/2014/02/140205091530.htm