# Prenatal Epigenetics: Trauma and Outcomes of Labor Dysfunction

> **NIH NIH F31** · EMORY UNIVERSITY · 2023 · $47,694

## Abstract

PROJECT SUMMARY
The United States spends more on maternity care than any other high-income country yet has rising rates of
severe maternal morbidity and mortality. Among other high-income countries, the U.S. ranks as the worst in
maternal morbidity and mortality rates. Moreover, there are significant disparities in severe maternal morbidity
and mortality, with Black pregnant people in the U.S. being more likely than white people to experience severe
maternal morbidity and mortality. Pregnant Black people are also disproportionately impacted by cumulative life
trauma, which is a life course social determinant of health (SDoH) strongly associated with poor perinatal
outcomes. One largely unexplored link between trauma and poor pregnancy outcomes in Black birthing people
is epigenetic changes in physiologic systems that are integral to both labor initiation and parturition and human
response to trauma. Among these are the hypothalamic-pituitary-adrenal axis (HPA-axis), oxytocinergic
system, and inflammatory response system function which have all been noted to have changes associated
with trauma exposure and play a role in parturition. The purpose of this NRSA fellowship is to utilize an
adapted allostatic load model to evaluate the effects of trauma on labor outcomes, through an epigenome wide
association study of DNA methylation, and its subsequent association with labor outcomes. We will leverage
biologic samples and survey data already being collected from two prospective cohorts (R011NR019254: PI
Dr. Nicole Carlson and R01MH115174: PI Dr. Vasiliki Michopoulos) of Black pregnant people living in the same
geographic area. We plan to evaluate if cumulative life trauma, as reported in early pregnancy, is associated
with labor dysfunction, including long labor duration and unplanned cesarean section. We theorize that trauma-
associated epigenetic changes may provide a missing link connecting Black pregnant people’s trauma
exposure with labor outcomes, thus providing insight into ways to optimize perinatal care for this population to
reduce racial inequities in labor outcomes. This project also includes a comprehensive training plan designed
to prepare a nurse-midwife clinician to be an independent research scientist with expertise in epigenetics,
trauma, and perinatal disparities research.

## Key facts

- **NIH application ID:** 10752023
- **Project number:** 1F31NR020847-01A1
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Abby Britt
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $47,694
- **Award type:** 1
- **Project period:** 2023-08-18 → 2025-08-17

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10752023

## Citation

> US National Institutes of Health, RePORTER application 10752023, Prenatal Epigenetics: Trauma and Outcomes of Labor Dysfunction (1F31NR020847-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10752023. Licensed CC0.

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