University of Kentucky

Exploring Racial Differences in Biomarkers, Stress and Anxiety throughout Pregnancy

Institution

University of Kentucky

Abstract

Introduction: Preterm birth (PTB) disproportionately affects African American (AA) women at nearly twice the rate of White (W) women. Prenatal stress and anxiety may contribute to increased levels of CRP associated with PTB. The inflammatory process triggers increased levels of CRP and IL-10. Gaps exist when identifying racial differences in reported prenatal stress and anxiety. The purpose of this study is to examine the relationship between prenatal stress, anxiety and IL-10 in racially diverse women. Method(s): A secondary analysis from a prospective multicenter study with repeated measures design was used. Each trimester, serum CRP and IL-10 were collected (n=143, n=128, and n=116) after survey administration. Maternal stress was also measured using the Everyday Stress Scale (ESS). Anxiety was measured using the State Trait Anxiety Inventory (STAI). Data analysis included descriptive statistics, Spearman Rho (ρ), and ANOVA using SAS 9.3. Results: AA women consistently reported higher stress than Hispanic or White women in all trimesters (p<.0001; p =.003; p =.0043). Similarly, AA reported significantly higher anxiety scores in the first and third trimesters (p=01;p=.01). White women consistently reported the lowest stress and anxiety scores. Overall, there is a significant, inverse correlation between self-reported maternal stress and IL-10 in the first and second trimester (ρ= - .21, p=.01; ρ= -.18, p=.05; however there was no association in the third trimester (ρ= -.07, p =.43). There was no association between maternal stress and CRP during any trimester of pregnancy. Furthermore, anxiety was not significantly associated with IL-10 or CRP. Conclusion: Throughout pregnancy, AA women report higher levels of stress and anxiety when compared to other races. High levels of maternal stress appear to decrease the potent antiinflammatory effects of IL-10; potentially providing mechanistic evidence of racial disparities for preterm birth. Further investigation of the relationship between IL-10, maternal stress and race is warranted.

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Exploring Racial Differences in Biomarkers, Stress and Anxiety throughout Pregnancy

Introduction: Preterm birth (PTB) disproportionately affects African American (AA) women at nearly twice the rate of White (W) women. Prenatal stress and anxiety may contribute to increased levels of CRP associated with PTB. The inflammatory process triggers increased levels of CRP and IL-10. Gaps exist when identifying racial differences in reported prenatal stress and anxiety. The purpose of this study is to examine the relationship between prenatal stress, anxiety and IL-10 in racially diverse women. Method(s): A secondary analysis from a prospective multicenter study with repeated measures design was used. Each trimester, serum CRP and IL-10 were collected (n=143, n=128, and n=116) after survey administration. Maternal stress was also measured using the Everyday Stress Scale (ESS). Anxiety was measured using the State Trait Anxiety Inventory (STAI). Data analysis included descriptive statistics, Spearman Rho (ρ), and ANOVA using SAS 9.3. Results: AA women consistently reported higher stress than Hispanic or White women in all trimesters (p<.0001; p =.003; p =.0043). Similarly, AA reported significantly higher anxiety scores in the first and third trimesters (p=01;p=.01). White women consistently reported the lowest stress and anxiety scores. Overall, there is a significant, inverse correlation between self-reported maternal stress and IL-10 in the first and second trimester (ρ= - .21, p=.01; ρ= -.18, p=.05; however there was no association in the third trimester (ρ= -.07, p =.43). There was no association between maternal stress and CRP during any trimester of pregnancy. Furthermore, anxiety was not significantly associated with IL-10 or CRP. Conclusion: Throughout pregnancy, AA women report higher levels of stress and anxiety when compared to other races. High levels of maternal stress appear to decrease the potent antiinflammatory effects of IL-10; potentially providing mechanistic evidence of racial disparities for preterm birth. Further investigation of the relationship between IL-10, maternal stress and race is warranted.