Why is Preterm Birth Stubbornly Higher in African-Americans?

Mohamed, Sara A.; Thota, Chandra; Browne, Paul; Diamond, Michael P.; Al-Hendy, Ayman

doi:10.15406/ogij.2014.01.00019

Cited by 14 publications

(10 citation statements)

References 12 publications

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“…The onset of parturition is characterized by a switch in the local immune environment from a tolerogenic state to an activation state, a reversal of decidual quiescence in favor of myometrial activation, and a withdrawal of P4 signaling. Maternal and paternal lifestyle factors (such as stress and nutrition), environmental factors, age, ethnicity, and genetics contribute to the success or failure of pregnancy, including the risk for PTB [9,12,13] and nucleic acids. The exchange of cells results in microchimerism in mother or fetus, whereby maternal cells transferred to the fetus are referred to as maternal microchimerism (MMC).…”

Section: Maternal-fetal Crosstalk and Reproductive Successmentioning

confidence: 99%

Pathogenesis of preterm birth: bidirectional inflammation in mother and fetus

2020

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Preterm birth (PTB) complicates 5–18% of pregnancies globally and is a leading cause of maternal and fetal morbidity and mortality. Most PTB is spontaneous and idiopathic, with largely undefined causes. To increase understanding of PTB, much research in recent years has focused on using animal models to recapitulate the pathophysiology of PTB. Dysfunctions of maternal immune adaptations have been implicated in a range of pregnancy pathologies, including PTB. A wealth of evidence arising from mouse models as well as human studies is now available to support that PTB results from a breakdown in fetal-maternal tolerance, along with excessive, premature inflammation. In this review, we examine the current knowledge of the bidirectional communication between fetal and maternal systems and its role in the immunopathogenesis of PTB. These recent insights significantly advance our understanding of the pathogenesis of PTB, which is essential to ultimately designing more effective strategies for early prediction and subsequent prevention of PTB.

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Section: Maternal-fetal Crosstalk and Reproductive Successmentioning

confidence: 99%

Pathogenesis of preterm birth: bidirectional inflammation in mother and fetus

2020

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“…Socioeconomic status (SES) is currently the most robust predictor of child developmental and health outcomes (1–3). Experiences of deprivation and trauma known to be associated with low SES play a key role in the process by which adversity negatively impacts brain development and health behaviors (4–7).…”

Section: Introductionmentioning

confidence: 99%

Disentangling Socioeconomic Status and Race in Infant Outcomes: A Neural Network Analysis

Sarullo

Barch

Smyser

et al. 2021

Preprint

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Race is commonly used as a proxy for multiple features including socioeconomic status. It is critical to dissociate these factors, identify mechanisms that impact infant outcomes, such as birthweight, and direct appropriate interventions and shape public policy. Demographic, socioeconomic, and clinical variables were used to model infant birthweight. Non-linear neural networks better model infant birthweight than linear models (R^2=0.172 vs. R^2=0.145, p-value=0.005). In contrast to linear models, non-linear models ranked income, neighborhood disadvantage, and experiences of discrimination higher in importance while modeling birthweight than race. Consistent with extant social science literature, findings suggest race is a linear proxy for non-linear factors. The ability to disentangle and identify the source of effects for socioeconomic status and other social factors that often correlate with race is critical for the ability to appropriately target interventions and public policies designed to improve infant outcomes as well as point out the disparities in these outcomes.

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“…Research suggests that prenatal stress, including racism, is associated with an increased risk of poor birth outcomes—preterm birth and low birthweight. African-American women experience more chronic stress in their lives than white women, mostly due to racial discrimination [3,5]. Further, risks of preterm birth and infant mortality are higher for black infants born to mothers residing in the most segregated cities and neighborhoods, and there is a positive correlation between preterm delivery and lower household income and medicaid eligibility.…”

Section: Introductionmentioning

confidence: 99%

17-α Hydroxyprogesterone Nanoemulsifying Preconcentrate-Loaded Vaginal Tablet: A Novel Non-Invasive Approach for the Prevention of Preterm Birth

et al. 2019

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Preterm birth (PTB) is a major cause of infant mortality in the United States and around the globe. Makena®—once-a-week intramuscular injection of 17-α Hydroxyprogesterone caproate (17P)—is the only FDA approved treatment for the prevention of PTB. Invasive delivery of 17P requires hospitalization and expert personnel for injection. Vaginal delivery of 17P would be preferable, because of high patient compliance, reduced systemic exposure, fewer side effects, and no need for hospitalization. The objective of the present study was to prepare and evaluate a self-nanoemulsifying vaginal tablet of 17P. A solid self-nanoemulsifying preconcentrate (S-SNEDDS) of 17P and dimethylacetamide (DMA) was developed using medium chain triglycerides, a non- immunogenic surfactant, and co-processed excipient (PVA-F100). The tablet prepared was characterized for emulsification time, particle size, solid state properties, and drug release. The formulation showed >50% inhibition of TNF-α release from LPS-stimulated RAW 264.7 cells. Importantly, there were significant differences in rates of PTB and average time to delivery between control and vaginal 17P-treated groups in LPS-stimulated timed pregnant E15.5 mice. Considering the lacuna of therapeutic approaches in this area, vaginal delivery of 17P for the prevention of preterm birth has significant clinical relevance.

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Why is Preterm Birth Stubbornly Higher in African-Americans?

Cited by 14 publications

References 12 publications

Pathogenesis of preterm birth: bidirectional inflammation in mother and fetus

Pathogenesis of preterm birth: bidirectional inflammation in mother and fetus

Disentangling Socioeconomic Status and Race in Infant Outcomes: A Neural Network Analysis

17-α Hydroxyprogesterone Nanoemulsifying Preconcentrate-Loaded Vaginal Tablet: A Novel Non-Invasive Approach for the Prevention of Preterm Birth

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