# Prenatal stress exposures and fetal inflammation during mid-gestation

> **NIH NIH R21** · EMORY UNIVERSITY · 2024 · $194,731

## Abstract

ABSTRACT
Maternal experiences of psychosocial stress (e.g., stressful life events, perceived stress, job strain, poor social
support) are associated with an increased risk of preterm birth and inflammation during pregnancy has been
implicated as a key mechanistic pathway. Epidemiologic studies have observed positive relationships between
psychosocial stressors and maternal inflammation levels. Similarly, inflammatory biomarkers, measured in
maternal samples during the second and third trimesters, have been associated with preterm birth. However,
how psychosocial stress and maternal inflammation both influence fetal inflammation during early to mid-
gestation remains unknown. This is problematic because most studies rely on maternal samples as proxies of
fetal health during mid-pregnancy. This knowledge gap persists in large part due to logistical and ethical
challenges in obtaining fetal tissue samples during mid-gestation. Closing this knowledge gap has implications
for improving fetal health across pregnancy, as elevated levels of maternal inflammation during early pregnancy
may lead to elevated levels of fetal inflammation later in gestation, which in turn can affect fetal development
and child health outcomes. Communities of color and low socioeconomic status individuals experience the
highest burden of multiple psychosocial stressors and are disproportionately affected by structural discrimination.
Accordingly, we will utilize a unique cohort of pregnant people who underwent elective pregnancy terminations
during the second trimester in San Francisco, CA between 2010 and 2016. This study population is racially,
ethnically, and demographically diverse, serving primarily low-income women of color with public health
insurance. We will, for the first time, measure a comprehensive panel of 24 inflammatory biomarkers in 114
previously banked maternal and cord sera and placenta samples. In parallel, we will quantify levels of
corticotropin-releasing hormone (CRH), FMS-like tyrosine kinase receptor (FLT1), and placental growth factor
(PlGF) in maternal sera. Our study, which leverages hard to obtain biospecimens from a critically important time
period, will be the first to examine the relationship between psychosocial stress and fetal inflammation during
mid-gestation. We will determine differences in abundances and assess correlations among biomarkers across
the three matrices (Aim 1). Further, we will examine relationships between psychosocial stress and maternal
and fetal inflammation and create inflammation scores for each matrix using factor analysis (Aim 2). We will also
use structural equation modeling to assess whether inflammation measured in cord serum is influenced by and
associated with maternal and placenta inflammation levels (Aim 3). Importantly, results from our study will
provide important insights on the health effects of historically marginalized populations during a time period that
is difficult to study. Understanding the origin...

## Key facts

- **NIH application ID:** 10833662
- **Project number:** 5R21HD109723-02
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Stephanie Marie Eick
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $194,731
- **Award type:** 5
- **Project period:** 2023-05-01 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10833662

## Citation

> US National Institutes of Health, RePORTER application 10833662, Prenatal stress exposures and fetal inflammation during mid-gestation (5R21HD109723-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10833662. Licensed CC0.

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