# The role of host-microbial interactions in altering preterm birth risk among black women

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2020 · $242,435

## Abstract

Abstract: There are stark disparities in perinatal outcomes between Black and non-Black women in the
United States. Even when controlling for socioeconomic status and medical comorbidities, Black women have
a higher rate of cesarean delivery, severe maternal morbidity (SMM) and overall maternal mortality (MM). In
fact, Black women die at three times the rate of white women during and following pregnancy. While racial
disparities in perinatal outcomes are multifactorial, there is increasing evidence that environmental
exposures—poverty, psychosocial factors, maternal adverse childhood experiences (ACE) and stress confer
significant health risk. For example, higher ACE scores have been linked to a host of negative physical and
psychosocial outcomes outside of pregnancy such as increased risk for cardiovascular disease, diabetes,
cancers, and depression. Similarly, higher ACE scores and higher stress have also been associated with
adverse pregnancy outcomes. Despite these findings, the biological underpinnings as to how early life
experiences and maternal stress may lead to MM and SMM remain a mystery. Our proposal will provide an
integrated and innovative approach to understand biological, specifically immunological, and sociocultural
factors that contribute to SMM. It is understood that the factors and causes leading to SMM and MM are
multifaceted. Yet, research in non-obstetrical populations have revealed important findings. First, perturbations
in immune function are key biological events contributing to disease states such as diabetes, hypertension and
adverse vascular phenotypes. Second, psychosocial stressors, specifically early life stressors, contribute to
adverse health outcomes and are implicated in observed racial disparities. There are large knowledge gaps as
to how psychosocial stressors may contribute to maternal morbidity and to the significant increases in maternal
morbidity and mortality among black women. We hypothesize that psychosocial stressors alter the functional
immune profile in pregnant women leading to diverse biological effects that predispose women to SMM and
MM. In our recently funded renewal RO1, we are enrolling 800 pregnant women or 200 per year. Inclusion
criteria for this study includes women to be self-reporting race as black. We are already obtaining psychosocial
metrics, such as adverse childhood events (ACE), perceived stress (PSS) and neighborhood deprivation. For
the period of this supplement, we propose to enroll 120 pregnant women, from the 200 expected in the parent
R01 in year 1, to participate in a sub-study to determine how maternal stress may perturb immune function. We
will assess functional immune profiles between 20-26 weeks to reflect a period prior to most maternal morbidity
events. We will compare the immune profile between black women who have high and low scores on the
psychosocial metrics as our primary outcome. As secondary outcome will be exploratory and will investigate
the association of ...

## Key facts

- **NIH application ID:** 10199658
- **Project number:** 3R01NR014784-06S1
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** MICHAL Aviva ELOVITZ
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $242,435
- **Award type:** 3
- **Project period:** 2013-09-28 → 2025-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10199658

## Citation

> US National Institutes of Health, RePORTER application 10199658, The role of host-microbial interactions in altering preterm birth risk among black women (3R01NR014784-06S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10199658. Licensed CC0.

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