Mechanisms Underlying Preterm Birth in Minority Women
william f. connell school of nursing
Susan Gennaro, Connell School Dean and Professor
Preterm birth is a serious concern, with many possible heath complications for the infant. This issue is of particular concern for minority women, who experience a significantly higher incidence of preterm birth. Identifying factors that predict preterm birth early in pregnancy is an important step toward decreasing preterm birth in minority women.
In African American women, most at risk for early preterm birth (<32 weeks gestation), mechanisms underlying preterm labor will be differentiated from those underlying preterm birth. As only 40-50% of preterm labor ends in PTB, understanding factors that differentiate preterm labor from preterm birth would enable clinicians to provide more effective care for preterm labor and birth.
Dr. Susan Gennaro and her research team will explicate factors predicting preterm birth in African American women by comparing them with factors predicting preterm birth in Mexican American women. Information about minority women most likely to labor prematurely but deliver at term and those most likely to experience preterm labor and delivery will be obtained in African American women, who are most at risk for early preterm birth, so that targeted interventions can be designed to improve the care of preterm labor and prevent preterm birth.
The aims of this study are to:
- Compare the predictive ability of stress, depression, coping, immune function, body mass index, and infection, measured between 22-24 weeks gestation, in identifying African American women who will deliver preterm from those who deliver at term.
a. Compare predictors of preterm birth at 22-24 weeks gestation in African American women with the same predictors of preterm birth in Mexican American women.
- Compare three groups of African American women (1) those women who labor and deliver prematurely, (2) those who labor prematurely but deliver at term, and (3) those who only experience term labor and delivery, to develop a predictive model of pregnancy outcomes in African American women, including a treatment decision tree for prenatal care, which is based on measures of stress, depression, coping, immune function, infection, and health behaviors.
- Examine, in African American women, the timing and contribution of mutable factors (stress, depression, coping, infections, smoking, and nutrition) between the onset of preterm labor (or 22-24 weeks of gestation for women who do not experience preterm labor and delivery) to delivery outcome.
The information obtained from this study will provide knowledge about psychosocial, behavioral and physiologic factors that underlie preterm labor and preterm birth and is necessary to develop effective nursing interventions to improve birth outcomes in minority women.