PROJECT SUMMARY
In the US, Black mothers and infants experience disproportionately worse pregnancy-related
health outcomes. Black mothers are 1.5-4 times more likely to die within a year of birth
compared to non-Black mothers, and Black infants are 2-3 times more likely to die compared to
non-Black infants. These elevated rates have further been tied to elevated rates of obstetric
cardiovascular complications for mothers, and preterm birth and low birthweight for infants. The
causes for these disparities are unknown, but evidence to date suggests that they are likely
social and environmental in nature. Thus, there is an urgent need to identify the determinants of
these racial disparities to elucidate the highest priority targets for intervention. The proposed
research will evaluate how micro- (e.g., interpersonal, family) and macro-level (e.g.,
neighborhood, environmental) risk and resiliency factors transact to shape maternal-infant
health. Additionally, this research interrogates the psychobiological mechanisms that underlie
their associations (i.e., physiological stress dysregulation, as indexed by i.e., salivary cortisol,
respiratory sinus arrhythmia, electrodermal activity). Specific aims are to: (1) determine the
intra- and intergenerational health consequences of maternal exposure to multi-level stressors
and resiliency factors both during pregnancy and across her life course, (2) evaluate the
mechanistic role of maternal and infant stress physiology in shaping maternal-infant health, and
(3) estimate the extent to which paternal support may promote maternal-infant health both
during pregnancy and the postpartum. To achieve these aims, this prospective longitudinal
study will follow 350 Black families (mothers, fathers, infants) from pregnancy through the first
postpartum year, with home visits during pregnancy, and at infant ages 6 and 12 months. This
research utilizes a multi-method approach, and draws from self-report, psychophysiological
assessment, behavioral observations, medical record abstraction, and spatial analyses using
Geographic Information Systems (GIS). Additionally, this research emphasizes risk (e.g.,
interpersonal and structural racism) and resiliency (e.g., racial identity, cultural beliefs and
values) factors of particular relevance for Black Americans. The long-term objective of this
research is to identify targets through which to promote health in generations of Black U.S.
families.
