Adverse Birth Outcomes in African American Women: The Social Context of Persistent Reproductive Disadvantage

Dominguez, Tyan Parker

doi:10.1080/10911350902986880

Cited by 86 publications

(86 citation statements)

References 47 publications

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“…The mechanisms that contribute to the racial disparities in the prevalence of low birth weight are not clear. However, societal stress resulting in race-specific inequalities in educational, health care, housing and employment opportunities may serve as a determinant that contributes to the African American reproductive disadvantage (46). The Amsterdam Born Children and their Development Study (219) and the Adverse Childhood Experiences Study (47) are being used to examine the link between stress in early life and later chronic disease.…”

Section: History and Etiology Of The Fetal Origins Of Cardiovascular DImentioning

confidence: 99%

Fetal Programming and Cardiovascular Pathology

Alexander

Dasinger

Intapad

2015

Comprehensive Physiology

178

129

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Low birth weight serves as a crude proxy for impaired growth during fetal life and indicates a failure for the fetus to achieve its full growth potential. Low birth weight can occur in response to numerous etiologies that include complications during pregnancy, poor prenatal care, parental smoking, maternal alcohol consumption or stress. Numerous epidemiological and experimental studies demonstrate that birth weight is inversely associated with blood pressure and coronary heart disease. Sex and age impact the developmental programming of hypertension. In addition, impaired growth during fetal life also programs enhanced vulnerability to a secondary insult. Macrosomia, which occurs in response to maternal obesity, diabetes and excessive weight gain during gestation, is also associated with increased cardiovascular risk. Yet, the exact mechanisms that permanently change the structure, physiology and endocrine health of an individual across their lifespan following altered growth during fetal life are not entirely clear. Transmission of increased risk from one generation to the next in the absence of an additional prenatal insult indicates an important role for epigenetic processes. Experimental studies also indicate that the sympathetic nervous system, the renin angiotensin system, increased production of oxidative stress and increased endothelin play an important role in the developmental programming of blood pressure in later life. Thus, this review will highlight how adverse influences during fetal life and early development program an increased risk for cardiovascular disease including high blood pressure and provide an overview of the underlying mechanisms that contribute to the fetal origins of cardiovascular pathology.

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Section: History and Etiology Of The Fetal Origins Of Cardiovascular DImentioning

confidence: 99%

Fetal Programming and Cardiovascular Pathology

Alexander

Dasinger

Intapad

2015

Comprehensive Physiology

178

129

View full text Add to dashboard Cite

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“…African-American women are exposed to disproportionately high levels of stress as a result of their race/ethnicity, gender, and socioeconomic position (Cole, 2009;Jackson, Hogue, & Phillips, 2005;Moradi & Subich, 2003;Nuru-Jeter et al, 2009;Rosenthal & Lobel, 2011;Woods-Giscombé & Lobel, 2008). Physiological responses to life stressors contribute to cardiovascular, immune, and neuroendocrine responses that, when experienced chronically, adversely influence health outcomes in African-American women, including hypertension, obesity, diabetes, untreated mental health conditions, and adverse birth outcomes such as preterm birth and low birth weight (American Psychiatric Association, 2015;Dominguez, 2011;Geronimus, Hicken, Keene, & Bound, 2006;Krieger, 2005;McEwen, 2012;Williams, 2009).…”

Section: Introductionmentioning

confidence: 99%

Whose Stress is Making Me Sick? Network-stress and Emotional Distress in African-American Women

Woods-Giscombé

Lobel

Zimmer

et al. 2015

Issues in Mental Health Nursing

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Research on stress-related health outcomes in African-American women often neglects "network-stress": stress related to events that occur to family, friends, or loved ones. Data from the African-American Women's Well-Being Study were analyzed to examine self-stress and network-stress for occurrence, perceived stressfulness, and association with symptoms of psychological distress. Women reported a higher number of network-stress events compared with self-stress events. Occurrences of network-stress were perceived as undesirable and bothersome as self-stress. Both types of stress were significantly associated with psychological distress symptoms. Including network-stress may provide a more complete picture of the stress experiences of African-American women.

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“…After controlling for other variables (e.g., body mass index, smoking), minority and low income women experience worse pregnancy outcomes, including a 64% increase in preterm birth in African American women compared to white women (Institute of Medicine, 2007), and their offspring fare worse in developmental, behavioral, and physical outcomes than infants born to non-minority women (Reichman et al, 2008). Reproductiveage African American and low income women also report increased levels of stress (Paul et al, 2008), a phenomenon these authors and others (Dominguez, 2011; Rich-Edwards and Grizzard, 2005) ascribe to race and class discrimination.…”

mentioning

confidence: 97%

Immune dysregulation and glucocorticoid resistance in minority and low income pregnant women

Corwin

Guo

Pajer

et al. 2013

Psychoneuroendocrinology

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Summary Chronic prenatal stress contributes to poor birth outcomes for women and infants. Importantly, poor birth outcomes are most common among minority and low income women. To investigate underlying mechanisms, we tested the hypothesis that chronic stress related to minority or low income status is associated with glucocorticoid resistance as indicated by disruption in the cytokine-glucocorticoid feedback circuit. Home visits were conducted during which 3rd trimester pregnant women completed stress and depression surveys and provided blood for pro- and anti-inflammatory cytokines. Saliva was collected 5 times the preceding day for diurnal cortisol levels. For statistical analyses, women were grouped 3 ways, by race, income, and the presence or absence of either of those risk factors; this last group was labeled high or low general risk. Immune regulation was evaluated by evidence of a functioning negative feedback relationship between cytokines and cortisol. Of 96 participants, 18 were minority, 22 of low income, and 29 either minority or low income (high general risk). Pearson partial correlation identified a significant negative relationship between cortisol area under the curve (AUC) and pro- to anti-inflammatory cytokine ratios in the low general risk women (i.e., Caucasian, higher income) including IFNγ/IL10 (r = −0.73, p < 0.0001), IL6/IL10 (r = 0.38, p = 0.01), IL1β/IL10 (r = −0.44, p = −0.004) and TNFα/IL10 (r = −0.41; p = 0.005); no such correlations existed in the high general risk women (i.e., minority, low income) for (IFNγ/IL10: r = −0.25, p = 0.43; IL6/IL10:r = 0.12, p = 0.70; IL1 β/IL10: r = 0.05, p = 0.87; TNFα/IL10: r = 0.10; p = 0.75), suggestive of glucocorticoid resistance. Cortisol levels throughout the day also were higher in minority and high general risk groups (p < 0.05). Without cytokine glucocorticoid feedback, a pregnant woman’s ability to regulate inflammation is limited, potentially contributing to adverse maternal and infant outcomes.

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Adverse Birth Outcomes in African American Women: The Social Context of Persistent Reproductive Disadvantage

Cited by 86 publications

References 47 publications

Fetal Programming and Cardiovascular Pathology

Fetal Programming and Cardiovascular Pathology

Whose Stress is Making Me Sick? Network-stress and Emotional Distress in African-American Women

Immune dysregulation and glucocorticoid resistance in minority and low income pregnant women

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