Immune dysregulation and glucocorticoid resistance in minority and low income pregnant women
Section snippets
Subjects recruitment and inclusion/exclusion criteria
The subjects were 96 women in the second or early third trimester of pregnancy who responded to ads placed in prenatal clinics and on community billboards. Subjects who met inclusion criteria during an initial phone conversation were scheduled for a home visit during their 32–36th week of pregnancy. Inclusion criteria were that each subject was between the ages of 18–40 years, anticipating a vaginal birth of a singleton fetus, in good health without pregnancy restrictions, a non-smoker, not
Statistical analysis
For comparative analyses, women were grouped three ways; first, as either Caucasian or of a racial/ethnic minority (Race), and second, as being either of high or low income (Income). These categories were determined by self-report of race/ethnicity and by self-report of participation in WIC or other government assistance programs respectively. For the third group, women were separated based on the presence or absence of either of the two risk factors: being minority or low income. This category
Results
Demographic data for the 96 pregnant women in this study are included in Table 1. As shown, 18 participants self-reported minority racial or ethnic status, 11 of whom self-identified as African American and 7 as Hispanic. Twenty two participants reported receiving government aid. Twenty-nine were of minority status or reported receiving government aid and were categorized as the high general risk group; 66 participants were Caucasian and did not receive government aid and were categorized as
Discussion
In this report, we describe the effects of chronic social stress on the relationship between cortisol and the pro-inflammatory cytokines in a uniquely vulnerable population, pregnant women. The most significant finding is that chronic stress related to minority status or low income was associated with elevated cortisol without a compensatory decrease in pro-inflammatory cytokine concentration; such a diminished negative feedback relationship between cortisol and pro-inflammatory cytokines is
Role of the funding source
This study was funded by a grant to Dr. Elizabeth J. Corwin (R01NR011278) from the National Institutes of Health, National Institute of Nursing Research (NINR). Without their generous contribution to all aspects of this study (subject recruitment and compensation, data collection, bioassays, etc.) this study could not have been accomplished.
Conflict of interest
All authors report no conflict of interest to disclose, including that related to any financial, personal or other relationships with other people or organizations within three years of beginning the work submitted.
Acknowledgements
The research reported in this article was supported by a grant from the National Institute of Nursing Research, R01 NR011278, to Elizabeth J. Corwin.
The authors thank Dr. Andrew H. Miller for his intellectual contributions to the manuscript. We also thank Laurel Ware, RN and Tina Fay, RN for their recruitment and data collection efforts, and Runfeng Jing, MD for conducting the bioassays.
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