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Matoba N, Collins JW, Dizon MLV. Fetal Origins of Health Disparities: Transgenerational Consequences of Racism. Dev Neurosci 2023; 46:112-118. [PMID: 37290414 DOI: 10.1159/000531462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 05/24/2023] [Indexed: 06/10/2023] Open
Abstract
Despite advances in perinatal medicine, racial disparity in birth outcomes remains a public health problem in the USA. The underlying mechanisms for this long-standing racial disparity are incompletely understood. This review presents transgenerational risk factors for racial disparities in preterm birth, exploring the impact of interpersonal and structural racism, theoretical models of stress, and biological markers of racial disparities.
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Affiliation(s)
- Nana Matoba
- Department of Pediatrics, Division of Neonatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Pediatrics, Division of Neonatology, University of California San Diego, Rady Children's Hospital San Diego, San Diego, California, USA
| | - James W Collins
- Department of Pediatrics, Division of Neonatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Maria L V Dizon
- Department of Pediatrics, Division of Neonatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Zhang P, Dygulski S, Al-Sayyed F, Dygulska B, Lederman S. Differences in Prevalence of Pregnancy Complications and Placental Pathology by Race and Ethnicity in a New York Community Hospital. JAMA Netw Open 2022; 5:e2210719. [PMID: 35511181 PMCID: PMC9073565 DOI: 10.1001/jamanetworkopen.2022.10719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/07/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- Peilin Zhang
- Department of Pathology, Weill Cornell Medicine, New York Presbyterian-Brooklyn Methodist Hospital Brooklyn, New York
| | - Sylvia Dygulski
- Department of Pediatrics, Weill Cornell Medicine, New York Presbyterian-Brooklyn Methodist Hospital Brooklyn, New York
| | - Farah Al-Sayyed
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York Presbyterian-Brooklyn Methodist Hospital Brooklyn, New York
| | - Beata Dygulska
- Department of Pediatrics, Weill Cornell Medicine, New York Presbyterian-Brooklyn Methodist Hospital Brooklyn, New York
| | - Sanford Lederman
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York Presbyterian-Brooklyn Methodist Hospital Brooklyn, New York
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Alvarado-Flores F, Savelyeva A, Chu T, Sadovsky Y, Amutah-Onukagha N, O'Tierney-Ginn P. Placental miRNAs Targeting Cellular Stress Response Pathways Are Highly Expressed in Non-Hispanic Black People. Reprod Sci 2022; 29:2043-2050. [PMID: 35194759 DOI: 10.1007/s43032-022-00895-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/16/2022] [Indexed: 11/25/2022]
Abstract
Non-Hispanic Black (NHB) people have a 2.5-fold higher risk of maternal mortality when compared to non-Hispanic White (NHW) people. Neonates of NHB people are more likely to be born preterm and small for gestational age, which may be driven by structural racism. The placenta is very sensitive to the maternal environment and may play a critical role in the translation of environmental stressors to pregnancy outcomes. Our aim was to assess the placental miRNA expression profile in both NHB and NHW people and the association between differentially expressed miRNAs and pregnancy outcomes. Placentas were collected from 50 NHB and 74 NHW people with a normal singleton pregnancy undergoing elective cesarean section at term prior to the onset of labor. Placental miRNA expression was measured via whole-genome small RNA-sequencing in a subset of 77 placentas. Fifteen miRNAs were more highly expressed in the placentas of NHB people. Several of these miRNAs were associated with cellular stress response pathways, suggesting that they may be responding to environmental stressors. Placental miR-192-5p expression was lower among NHB people and was positively associated with neonatal adiposity, suggesting it may be sensitive to structural racism with potential impacts on fetal growth.
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Affiliation(s)
- Fernanda Alvarado-Flores
- Mother Infant Research Institute, Tufts Medical Center, 800 Washington Street, Box #394, Boston, MA, 02111, USA
| | - Anastasia Savelyeva
- Mother Infant Research Institute, Tufts Medical Center, 800 Washington Street, Box #394, Boston, MA, 02111, USA
| | - Tianjiao Chu
- Magee Womens Research Institute, Pittsburgh, PA, USA
| | - Yoel Sadovsky
- Magee Womens Research Institute, Pittsburgh, PA, USA
| | - Ndidiamaka Amutah-Onukagha
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Perrie O'Tierney-Ginn
- Mother Infant Research Institute, Tufts Medical Center, 800 Washington Street, Box #394, Boston, MA, 02111, USA.
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Oldenburg KS, Eaves LA, Smeester L, Santos HP, O'Shea TM, Fry RC. Development of the genomic inflammatory index (GII) to assess key maternal antecedents associated with placental inflammation. Placenta 2021; 111:82-90. [PMID: 34182215 DOI: 10.1016/j.placenta.2021.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/21/2021] [Accepted: 06/15/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Placental inflammation is associated with a variety of adverse health outcomes, including poor pregnancy outcomes as well as later in life health. The current clinical methodologies for evaluating placental histology for inflammation are limited in their sensitivity. The objective of this study was to develop a genomic inflammatory index (GII) that can be utilized as a biomarker to effectively quantify and evaluate placental inflammation. METHODS RNA-sequencing of n = 386 placentas from the Extremely Low Gestational Age Newborn (ELGAN) cohort was conducted. Transcriptional data for a biologically-targeted set of 14 genes, selected for their established role in pro-inflammatory signaling pathways, were aggregated to construct the GII. Multiple linear regression models were used to examine relationships between 47 perinatal factors and the GII. RESULTS The GII demonstrated a nine-fold difference across subjects and displayed positive trends with other indicators of placental inflammation. Significant differences in the GII were observed for race where women who self-identified as Black displayed higher levels of placental inflammation than those who self-identified as White women (p < 0.001). Additionally, married Black women showed reduced placental inflammation compared to those who were unmarried (beta value: 0.828, p-value: 0.032). Placentas from women who were treated with steroids during the delivery of the infant displayed higher GII levels than those who were not (p = 0.023). DISCUSSION Overall, the GII demonstrated an association between various perinatal factors and placental inflammation. It is anticipated that the GII will provide a novel genomics tool for quantifying placental inflammation, allowing for further investigation of causes, and ultimately the prevention, of inflammation in the placenta.
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Affiliation(s)
- Kirsi S Oldenburg
- Department of Environmental Sciences & Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lauren A Eaves
- Department of Environmental Sciences & Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lisa Smeester
- Department of Environmental Sciences & Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hudson P Santos
- Department of Environmental Sciences & Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Biobehavioral Laboratory, School of Nursing, University of North Carolina, Chapel Hill, NC, USA
| | - T Michael O'Shea
- Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Rebecca C Fry
- Department of Environmental Sciences & Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill, NC, USA.
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Matoba N, Mestan KK, Collins JW. Understanding Racial Disparities of Preterm Birth Through the Placenta. Clin Ther 2021; 43:287-296. [PMID: 33483135 DOI: 10.1016/j.clinthera.2020.12.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/16/2020] [Accepted: 12/21/2020] [Indexed: 01/13/2023]
Abstract
The racial disparity associated with preterm birth is a public health concern in the United States. The placenta is the principal metabolic, respiratory, and endocrine organ of the fetus and a key route by which environmental exposures are transmitted from mother to offspring. Available at every delivery, it may serve as a marker of differences in prenatal exposures that manifest differently by race. Recently, we described differences in placental pathology between African-American and White preterm births: the prevalence of chronic inflammation was higher among African-American women's placentas compared with those of White women. Similarly, racial differences have been shown in placental malperfusion and placental weight. Social determinants such as poverty and stress from discrimination have been implicated in racial disparities in preterm birth. To date, however, the underlying biological mechanisms, whether through inflammatory, oxidative stress, or other pathways involving epigenetic programming, remain largely unknown. The placenta, complemented by maternal and umbilical cord blood biomarkers, may provide important information on the perinatal environment that explains the origins of racial disparities in preterm birth rates and subsequent health outcomes. This article reviews existing literature and current research gaps. Opportunities are discussed for future placental research that may reveal novel mechanisms leading to the development of new approaches in the prevention and management of preterm birth and its outcomes.
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Affiliation(s)
- Nana Matoba
- Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Department of Pediatrics, Division of Neonatology, Chicago, IL, USA.
| | - Karen K Mestan
- Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Department of Pediatrics, Division of Neonatology, Chicago, IL, USA
| | - James W Collins
- Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Department of Pediatrics, Division of Neonatology, Chicago, IL, USA
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