# Epigenomic Pathways from Racism to Preterm Birth

> **NIH NIH R01** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2024 · $399,380

## Abstract

Preterm birth (PTB) is a leading cause of perinatal morbidity and mortality, with long-term sequelae for both
mother and infant. Despite many known risk factors for PTB, prevention and treatment options are limited.
Non-Hispanic (NH) Black women are 2-3 times more likely to experience PTB compared to NH White women,
and some subgroups of Hispanic women also have increased risk. Racism has been hypothesized as a root
cause of perinatal health inequities in the United States (U.S.), yet its mechanisms remain understudied.
Epigenetics is a field with great promise for understanding how racism affects gene expression and identifying
risk for adverse birth outcomes among women of color. Most studies of epigenomics in pregnancy have had
low representation of NH Black and Hispanic women, and few have included structural racism exposures.
Further, prospective analyses from early pregnancy to birth outcomes are lacking, limiting identification of high-
risk women for improved prenatal surveillance. We propose to address these crucial knowledge gaps by
leveraging one of the largest and best-phenotyped cohorts to date, the nuMoM2b Study (2010-2015), a
multicenter, longitudinal cohort study of nulliparous pregnant women across the U.S. Existing data from this
study include: extracted maternal DNA from blood, Krieger’s individual experiences of discrimination,
geocoded participant addresses, pregnancy complications, and birth outcomes. We have assembled a
multidisciplinary team with expertise in maternal stress, epigenomics, and perinatal health inequities to
complete three aims. Aim 1: Determine the interactive effects of individual- and structural- level racism on PTB
among NH Black, Hispanic, and NH White participants (n=8,681). We will use the experiences of
discrimination scale score for individual level racism, and derive six measures of structural racism: residential
segregation, income, immigrant political climate, political participation, judicial treatment, and homeownership.
We will study within-racial and ethnic group differences in PTB; and then examine multilevel (the interaction of
individual and structural) racism in the whole group to determine if racism explains the excess PTB observed in
NH Black and Hispanic women. Aim 2: Characterize the methylome of all NH Black women in the cohort
(n=1,306). We will conduct an epigenome-wide association study of early pregnancy and study candidate
genes on stress pathways leading to PTB. Aim 3: Identify whether DNA methylation mediates the association
between multilevel racism and PTB among NH Black women (n=1,306). Aims 2 and 3 focus on NH Black
women as they bear the highest burden of PTB. This study will be the largest to examine multilevel racism
factors and epigenomics in pregnancy among NH Black women. Findings will address knowledge gaps by 1)
contributing epigenomic data towards discovery of mechanisms underlying PTB and other adverse birth
outcomes in Black women; and 2) informing health policy...

## Key facts

- **NIH application ID:** 10808856
- **Project number:** 5R01HD110429-02
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Veronica Barcelona
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $399,380
- **Award type:** 5
- **Project period:** 2023-03-14 → 2028-02-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10808856

## Citation

> US National Institutes of Health, RePORTER application 10808856, Epigenomic Pathways from Racism to Preterm Birth (5R01HD110429-02). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10808856. Licensed CC0.

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