# RISK FACTORS FOR RACIAL DISPARITIES IN ADVERSE PERINATAL OUTCOMES AFFECTING AFRICAN AMERICAN WOMEN

> **NIH NIH U54** · MEHARRY MEDICAL COLLEGE · 2024 · $425,300

## Abstract

PROJECT SUMMARRY
The Overarching Goal for our project is to better understand the impact of environmental stressors (i.e., due to
demographic, socioeconomic, and/or psychosocial factors) on the incidence of gestational poor sleep quality
that we predict triggers adverse pregnancy outcomes (APO; i.e., gestational diabetes, preeclampsia, fetal growth
restriction, premature delivery, hemorrhage, and stillbirths) more prevalent in African American women than
Caucasian women. Our Central Hypothesis is that “High Levels of Psychosocial and Socioeconomic Stressors
Alter Gestational Sleep Quality, Reduce Coping Response, and Impair Glucose Tolerance Resulting in Adverse
Pregnancy Outcomes”. To test this, we will enroll 256 otherwise healthy pregnant (singleton) African American
women (ages 18-40 years) and followed starting from 12-14 weeks of gestation. Thus, under Aim 1 we will
qualitatively and quantitatively measure sleep quality coupled with evaluation of demographic, socioeconomic
status (SES), and psychosocial status )PSS). In Aim 2, we will assess how poor sleep quality affects
physiological functions for the regulation of maternal nutrients (glucose, amino acids, lipids). We will collect blood
and saliva samples and measure key hormones regulating metabolism (insulin, corticotropin-releasing hormone
(CRH), free and total cortisol), and carrier proteins (CRH-binding protein, cortisol-binding globulins). Finally, in
Aim 3, we will determine the association between poor sleep quality versus gestational diabetes, preeclampsia,
and stress levels during gestation. Several interrelated clinical biomarkers will be quantified to verify the physical
and health status of participants (i.e., hemoglobin A1c, cortisol, C-reactive protein, lipid panel, and
comprehensive metabolic panel), respectively. Altogether, we expect to find that high levels of SES and PSS
predispose African American women to gestational poor sleep quality and adverse pregnancy outcomes.
Impact and Innovation: This study will yield new knowledge on the impact of low socioeconomic status and
psychosocial stress on gestational sleep quality and APO in African American women. This may partly account
for the disparities in APO since African Americans typically deal with a heavy burden of psychosocial and
socioeconomic stress in the American society. Overall, the concept that gestational poor sleep quality is a potent
risk factor able to ‘unbalance’ the intricate catabolic state that occurs in the second half of pregnancy is novel. If
validated this will uniquely inform screening tests for early detection of poor sleep quality during gestation and
implementation of evidence-based non-drug strategies for the curtailment of disparities in APO.

## Key facts

- **NIH application ID:** 10854841
- **Project number:** 5U54MD007586-38
- **Recipient organization:** MEHARRY MEDICAL COLLEGE
- **Principal Investigator:** SANIKA SAMUEL CHIRWA
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $425,300
- **Award type:** 5
- **Project period:** 1997-09-30 → 2027-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10854841

## Citation

> US National Institutes of Health, RePORTER application 10854841, RISK FACTORS FOR RACIAL DISPARITIES IN ADVERSE PERINATAL OUTCOMES AFFECTING AFRICAN AMERICAN WOMEN (5U54MD007586-38). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10854841. Licensed CC0.

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