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Medicine (Baltimore). 2017 Feb;96(5):e5899. doi: 10.1097/MD.0000000000005899.

Differential effects of stress and African ancestry on preterm birth and related traits among US born and immigrant Black mothers.

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aDivision of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Zhunan bDepartment of Public Health, China Medical University, Taichung, Taiwan. cDepartment of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL dDepartment of International Health, Bloomberg School of Public Health eCenter on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore fGlobal Health and Education Projects, Inc., Riverdale, MD gAnn & Robert H. Lurie Children's Hospital of Chicago, Stanley Manne Children's Research Institute, Chicago, IL hDepartment of Pediatrics, Boston University School of Medicine and Boston Medical Center, Boston, MA iDivision of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.


Preterm birth (PTB, <37 weeks of gestation) is influenced by a wide range of environmental, genetic and psychosocial factors, and their interactions. However, the individual and joint effects of genetic factors and psychosocial stress on PTB have remained largely unexplored among U.S. born versus immigrant mothers.We studied 1121 African American women from the Boston Birth Cohort enrolled from 1998 to 2008. Regression-based analyses were performed to examine the individual and joint effects of genetic ancestry and stress (including lifetime stress [LS] and stress during pregnancy [PS]) on PTB and related traits among U.S. born and immigrant mothers.Significant associations between LS and PTB and related traits were found in the total study population and in immigrant mothers, including gestational age, birthweight, PTB, and spontaneous PTB; but no association was found in U.S. born mothers. Furthermore, significant joint associations of LS (or PS) and African ancestral proportion (AAP) on PTB were found in immigrant mothers, but not in U.S. born mothers.Although, overall, immigrant women had lower rates of PTB compared to U.S. born women, our study is one of the first to identify a subset of immigrant women could be at significantly increased risk of PTB and related outcomes if they have high AAP and are under high LS or PS. In light of the growing number of immigrant mothers in the U.S., our findings may have important clinical and public health implications.

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