PROJECT SUMMARY Adverse birth outcomes in infants affect health over the life course, and preeclampsia and postpartum depression contribute significantly to maternal morbidity and mortality. Neighborhood deprivation and discrimination are associated with these adverse perinatal outcomes and their disparities, but it is difficult to develop interventions to limit these harmful exposures. Research suggests that social support is a modifiable characteristic that can buffer against the adverse effects of maternal stress on some birth outcomes, but less is known about its potential to buffer the effects of neighborhood deprivation and discrimination on perinatal outcomes. Aim 1 will evaluate the degree to which prenatal social support modifies the effect of neighborhood deprivation on adverse birth outcomes, including preterm birth, low birth weight, and small for gestational age. Aim 2 will examine the degree to which prenatal social support modifies the effect of neighborhood deprivation on preeclampsia. Aim 3 will investigate the degree to which postnatal social support modifies the effect of discrimination on postpartum depression. The Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to- Be multi-site cohort of 9,289 pregnancies will be used for Aims 1 and 2. In this cohort, neighborhood deprivation was measured by the Area Deprivation Index (ADI) and social support was measured by the Multidimensional Scale of Perceived Social Support (MSPSS). The Community and Child Health Network multi-site cohort of 2,510 pregnancies will be used for Aim 3. In this cohort, discrimination was measured by the Everyday Discrimination Scale (EDS), postnatal social support was measured by the Medical Outcomes Study (MOS) Social Support Scale, and postpartum depression was measured by the Edinburgh Postnatal Depression Scale (EPDS) at 1, 6, and 12 months postpartum. The hypothesis is that the adverse effects of neighborhood deprivation and discrimination on perinatal outcomes will be diminished among women with high perceived social support compared to women with low perceived social support and secondarily that this buffering effect will differ by racial group and by type of social support. Our findings could help inform the value of psychosocial risk screening in prenatal care to assist in identifying pregnant women most likely to benefit from resources such as support groups, insurance-covered doulas, and new interventions developed with a nuanced understanding of which types of social support are most effective and for which outcomes. The planned research and training goals will enrich the applicant’s rigorous training in advanced epidemiologic methods, psychosocial epidemiology, perinatal health disparities, and prenatal clinical care, as well as provide professional development in preparation for her transition to a postdoctoral fellowship. Equipped with a strong mentoring team and Emory’s rich training environment, this fellowship will provide a stron...