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Pediatr Res. 2016 Jan;79(1-2):136-40. doi: 10.1038/pr.2015.191. Epub 2015 Oct 13.

Epigenetics: linking social and environmental exposures to preterm birth.

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Department of Neonatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts.
Department of Preventive Medicine, Icahn School of Medicine at Mt. Sinai, New York, New York.
Mindich Child Health & Development Institute, Icahn School of Medicine at Mt. Sinai, New York, New York.
Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mt. Sinai, New York, New York.


Preterm birth remains a leading cause of infant mortality and morbidity. Despite decades of research, marked racial and socioeconomic disparities in preterm birth persist. In the Unites States, more than 16% of African-American infants are born before 37 wk of gestation compared with less than 11% of white infants. While income and education differences predict a portion of these racial disparities, income and education are proxies of the underlying causes rather than the true cause. How these differences lead to the pathophysiology remains unknown. Beyond tobacco smoke exposure, most preterm birth investigators overlook environment exposures that often correlate with poverty. Environmental exposures to industrial contaminants track along both socioeconomic and racial/ethnic lines due to cultural variation in personal product use, diet, and residential geographical separation. Emerging evidence suggests that environmental exposure to metals and plasticizers contribute to preterm birth and epigenetic modifications. The extent to which disparities in preterm birth result from interactions between the social and physical environments that produce epigenetic modifications remains unclear. In this review, we highlight studies that report associations between environmental exposures and preterm birth as well as perinatal epigenetic sensitivity to environmental contaminants and socioeconomic stressors.

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