The health disparity in preterm birth (PTB) that exists in the United States (US) is a national crisis. Pregnant
Black women have a 50% higher risk of PTB compared to pregnant White women in the US, and their
infants are more than twice as likely to die. This disparity continues despite decades of research and tried
intervention. Over ten years ago, the National Academy of Medicine identified Black women’s exposure to
chronic stress as among the most important risk factors contributing to this health disparity and called for
additional research as necessary. Although additional research has been conducted, the high rates of PTB
among Black women have continued unabated. Thus, to address this significant critical need, we have
brought together an exemplary team of researchers and clinicians with unique and complementary expertise.
With this team, we will conduct a first of its kind clinic trial: testing the efficacy of a 10-week, live, culturally
congruent music intervention compared to a similarly delivered 10-week sham control, to reduce the
biological impact of chronic stress at the most fundamental level -- the molecules and metabolic pathways
that are affected by stress. We further propose implementing the Music Characterization System (MCS) to
identify the musical mechanisms underlying any benefit. Black women in the US often are exposed to
chronic stress related to their race, sex, socioeconomic status, and social determinants of health including
neighborhood and household food insecurity. Our study stems from our team’s previous research
demonstrating that within a similar population of pregnant Black women, chronic stress was associated with
changes in maternal metabolites and metabolic pathways linked to oxidative stress, energy production, and
myelination, all potentially influencing pregnancy and newborn outcomes. This study also stems from our
team’s rigorous research showing the power of live music to reduce stress and improve outcomes. Based on
the National Institute of Minority Health and Health Disparities Research Framework, we will recruit 142
pregnant Black women during their 1st trimester of pregnancy and implement the Music Intervention or sham
control beginning in the 2nd trimester. Women will collect saliva samples for later metabolomic analysis and
complete surveys at the 1st, 5th, and 10th-week verbal or sham session. Birth outcomes will be determined
from careful review of the labor and delivery record. Music is one of the earliest, most traditional art forms in
human history, while metabolomics is one of the newest and most advanced technologies available in the
world today. By combining the very old with the very new in this innovative study, we have the opportunity to
identify a means by which the beneficial effects of live, culturally relevant music chosen by a pregnant
woman and implemented therapeutically, can reduce the biological impact of the daily stressors to which she
is exposed, and as a result, reduce one of the most persistent health disparities of our time, PTB.
