title: The relationship between race, inflammation and psychosocial factors among pregnant women.
abstract: African American women have higher rates of preterm birth (PTB) than women from other racial or ethnic backgrounds. We explored the possibility that African American women experience higher anxiety/lower optimism levels, leading to excess inflammation, a possible pathway leading to PTB. In a cohort of 434 nulliparous women (African American, n = 119; Caucasian, n = 315), standardized measures of anxiety and optimism were completed at 20 weeks' gestation. C-reactive protein (CRP) was measured in serum collected at the same time, and interleukin-6 (IL-6) was additionally measured in African American women. African American women tended to have higher rates of anxiety (>75th percentile) compared to Caucasian women (27.3 vs. 19.2%, p = 0.08), but rates of low optimism (<25th percentile) did not vary by race. Contrary to our hypothesis, higher concentrations of CRP among African American women were associated with lower risk of anxiety in the highest quartile, adjusted for covariates (OR 0.65, 95% CI 0.44, 0.98). Low optimism in African American women was also associated with lower IL-6, but results were only marginally significant (OR 0.43, 95% CI 0.17, 1.10). CRP, anxiety, and optimism were not correlated among Caucasian women. African American women with high anxiety or low optimism had lower concentrations of pro-inflammatory markers at mid-gestation compared to those without these characteristics. Our results suggest that chronic anxiety among African American women may contribute to intractable race disparities in pregnancy outcomes via an impaired inflammatory response.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Science, University of Pittsburgh School of Medicine, 300 Halket St., Pittsburgh, PA, 15213, USA, catovjm@upmc.edu.
authors.forename: Janet M
authors.initials: JM
authors.lastname: Catov
authors.forename: Melanie
authors.initials: M
authors.lastname: Flint
authors.forename: MinJae
authors.initials: M
authors.lastname: Lee
authors.forename: James M
authors.initials: JM
authors.lastname: Roberts
authors.forename: Diane J
authors.initials: DJ
authors.lastname: Abatemarco
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000208:ethnology; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005865:Gestational Age; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000208:ethnology; D018836:Inflammation Mediators; D016015:Logistic Models; D008429:Maternal Welfare; D015999:Multivariate Analysis; D016017:Odds Ratio; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000208:ethnology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology; D011256:Pregnancy Outcome / Q000208:ethnology*; D047928:Premature Birth / Q000208:ethnology*; D011584:Psychology; D012189:Retrospective Studies; D018570:Risk Assessment; D014481:United States; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D018836:Inflammation Mediators