A Biological Mechanism for Adverse Maternal-Child Outcomes in Disadvantaged Populations

2.50
Hdl Handle:
http://hdl.handle.net/10755/304309
Category:
Full-text
Type:
Presentation
Title:
A Biological Mechanism for Adverse Maternal-Child Outcomes in Disadvantaged Populations
Author(s):
Corwin, Elizabeth; Guo, Ying; Dunlop, Anne
Lead Author STTI Affiliation:
Alpha Epsilon
Author Details:
Elizabeth Corwin, RN, PhD, FNP, ejcorwi@emory.edu; Ying Guo, PhD; Anne Dunlop, MD;
Abstract:

Session presented on: Wednesday, July 24, 2013

Purpose: This study aimed to explore mechanisms underlying adverse health outcomes in minority women. Minority women experience higher rates of perinatal complications compared to Caucasian women and higher risk of chronic disease across the lifespan. Biological and social contributors have been proposed to explain these disparities yet underlying mechanisms remain unclear. We tested the hypothesis that minority pregnant and postpartum women are unable to regulate inflammatory and stress responses compared to Caucasian women.

Methods: Data was collected from women were during the 3rd trimester of pregnancy through 6-months postpartum. Plasma was collected for pro- and anti-inflammatory cytokine levels and saliva 5 times the preceding day for cortisol levels and area under the curve (AUC). Linear regression was used to assess differences in pro- and anti-inflammatory cytokine ratios and cortisol. Demographic variables significantly different between groups were controlled for in analyses.

Results: Of 113 participants, 23 were of minority status. Minority women were younger (p=0.01) and of lower income' (p< 0.05). Controlling for age and income, minority women had higher cortisol secretion, as indicated by area under the curve (AUC) than Caucasian women prenatally (p=0.021) and at 6-months (p=0.02) especially at the time points of 11AM (prenatal p=0.01; 6-month p = 0.02) and 4PM (prenatal p=0.04; 6-month p=0.02). An increase in pro- to anti-inflammatory cytokine ratio of interleukin-1 beta to interleukin-10 was found in minority compared to Caucasian women at 1- (p=0.02) and 3-months (p=0.01) postpartum indicating increased pro-inflammatory profile.

Conclusion: This study suggests social disadvantage related to minority status is associated with activation of the stress response and dysregulation of the inflammatory response in a vulnerable population, pregnant and postpartum women. Elevated cortisol and increased inflammation are known risk factors for poor perinatal outcomes and poor long term health and may contribute to the health disparity seen across the lifespan in minority women.

Keywords:
pregnancy and the postpartum period; chronic stress; health disparity
Repository Posting Date:
22-Oct-2013
Date of Publication:
22-Oct-2013 ; 22-Oct-2013
Conference Date:
2013
Conference Name:
24th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Prague, Czech Republic
Description:
24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.language.isoenen
dc.type.categoryFull-texten
dc.typePresentationen
dc.titleA Biological Mechanism for Adverse Maternal-Child Outcomes in Disadvantaged Populationsen
dc.contributor.authorCorwin, Elizabethen
dc.contributor.authorGuo, Yingen
dc.contributor.authorDunlop, Anneen
dc.contributor.departmentAlpha Epsilonen
dc.author.detailsElizabeth Corwin, RN, PhD, FNP, ejcorwi@emory.edu; Ying Guo, PhD; Anne Dunlop, MD;en
dc.identifier.urihttp://hdl.handle.net/10755/304309-
dc.description.abstract<p>Session presented on: Wednesday, July 24, 2013</p><b>Purpose: </b> This study aimed to explore mechanisms underlying adverse health outcomes in minority women. Minority women experience higher rates of perinatal complications compared to Caucasian women and higher risk of chronic disease across the lifespan. Biological and social contributors have been proposed to explain these disparities yet underlying mechanisms remain unclear. We tested the hypothesis that minority pregnant and postpartum women are unable to regulate inflammatory and stress responses compared to Caucasian women. <p><b>Methods: </b> Data was collected from women were during the 3<sup>rd</sup> trimester of pregnancy through 6-months postpartum. Plasma was collected for pro- and anti-inflammatory cytokine levels and saliva 5 times the preceding day for cortisol levels and area under the curve (AUC). Linear regression was used to assess differences in pro- and anti-inflammatory cytokine ratios and cortisol. Demographic variables significantly different between groups were controlled for in analyses. <p><b>Results: </b>Of 113 participants, 23 were of minority status. Minority women were younger (p=0.01) and of lower income' (p< 0.05). Controlling for age and income, minority women had higher cortisol secretion, as indicated by area under the curve (AUC) than Caucasian women prenatally (p=0.021) and at 6-months (p=0.02) especially at the time points of 11AM (prenatal p=0.01; 6-month p = 0.02) and 4PM (prenatal p=0.04; 6-month p=0.02). An increase in pro- to anti-inflammatory cytokine ratio of interleukin-1 beta to interleukin-10 was found in minority compared to Caucasian women at 1- (p=0.02) and 3-months (p=0.01) postpartum indicating increased pro-inflammatory profile. <p><b>Conclusion: </b>This study suggests social disadvantage related to minority status is associated with activation of the stress response and dysregulation of the inflammatory response in a vulnerable population, pregnant and postpartum women. Elevated cortisol and increased inflammation are known risk factors for poor perinatal outcomes and poor long term health and may contribute to the health disparity seen across the lifespan in minority women. <p><quickprintreadystate></quickprintreadystate>en
dc.subjectpregnancy and the postpartum perioden
dc.subjectchronic stressen
dc.subjecthealth disparityen
dc.date.available2013-10-22T20:33:17Z-
dc.date.issued2013-10-22-
dc.date.issued2013-10-22en
dc.date.accessioned2013-10-22T20:33:17Z-
dc.conference.date2013en
dc.conference.name24th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationPrague, Czech Republicen
dc.description24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.en
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