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Study investigates risk and protective factors for preterm birth in African American women

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The Nell Hodgson Woodruff School of Nursing received a five-year, $1.9 million award from the National Institute of Minority Health and Health Disparities to investigate risks and protective factors that contribute to high rates of preterm birth in African-American women. The proposed research will help identify strategies for ameliorating racial disparities in preterm birth.

On-going surveillance has established that African-American women have greater than 1.5 times the risk of preterm birth than Caucasian women, making preterm birth the leading cause of infant mortality for African Americans.

The research team, led by Anne Dunlop, MD, MPH, associate professor of research at Emory’s Nell Hodgson Woodruff School of Nursing, and Alicia Smith, PhD, assistant professor in the Department of Psychiatry and Behavioral Sciences at Emory University School of Medicine, will determine whether the biologic, social, behavioral and environmental elements -- known as biobehavioral factors --that are linked to preterm birth influence the expression of genes that contribute to preterm birth in African American women.

"Our research contributes to a biopsychosocial understanding of within-race risks for preterm birth," explains Dunlop. "We believe that among African-American women there are specific biobehavioral factors that trigger epigenetic mechanisms that increase the risk of preterm birth. If we can define these risk factors for African American women, we can begin to identify important intervention strategies to benefit African-American women." 

Epigenetics is the investigation of the outside components, or biobehavioral factors, influencing the carefully orchestrated chemical reactions that activate and deactivate parts of the genome. Unlike DNA, the epigenome reacts to biobehavioral factors and affects the expression of specific genes in response.  The various effects of these reactions include outcomes such as preterm birth.

In this study, Dunlop and Smith and their team will leverage data from an ongoing NIH-funded prospective cohort study of pregnant African-American women of diverse sociodemographic status to assess women’s prenatal stress, dietary intake, and health behaviors; microbiome composition; and birth outcomes. The newly funded study will enable the researchers to explore the hypothesis that epigenetic mechanisms influence the relationship between these biobehavioral factors and preterm birth for African-American women. They aim to characterize epigenetic changes among African- American women, identify biobehavioral factors that influence the epigenetic changes and evaluate the relationships of these factors with preterm birth.

"We believe that through these explorations our team will identify modifiable factors that influence the epigenetic regulation of genes involved in preterm birth," explains Dunlop. "Our study is a vital step in promoting the understanding of the biological mechanisms involved in conditions that disproportionately affect minority populations."


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