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Racialized inequities in birth outcomes and maternal health following childbirth: the role of maternal early-life disadvantage, adolescent contexts, and pre-pregnancy stress

Award Number: R21HD115143
ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/15/2024
PERIOD OF PERFORMANCE END DATE: 08/14/2026

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Racialized inequities in birth outcomes and maternal health following childbirth: the role of maternal early-life disadvantage, adolescent contexts, and pre-pregnancy stress - PROJECT SUMMARY/ABSTRACT: This proposed study assesses how social contextual stressors over the maternal pre-pregnancy life course contribute to the unacceptably wide racialized inequities in maternal and infant health in the United States (US). It aims at uncovering whether and how adolescent girls’ social developmental contexts shape biosocial stress pathways affecting maternal health and birth outcomes. It uses secondary analysis of newly available data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a novel, US-representa- tive longitudinal cohort with five data collection waves beginning in adolescence and including social, contex- tual, health, and birth outcome measures. The central hypothesis is that adolescence is a pivotal early-life pe- riod for racialized social stressors before pregnancy that affect future maternal and infant health, including through pathways associated with accelerated maternal aging and stress-related weathering that may have lasting impacts on maternal mental health. This hypothesis is based on early analyses by the study team re- vealing age-related declines in birth weight and increases in maternal depression risk among Black, but not White, mothers in Add Health—particularly when exposed to more severe early-life disadvantage. The pro- posed analyses will further investigate aspects of adolescent contexts, linked lives over the life course, and biosocial stress mechanisms that may serve as leverage points for future research and interventions to achieve maternal and infant health equity. The study team will analyze Add Health cohort data spanning all five collection waves, from ages 12 to 43, including new epigenetic markers of maternal stress and aging. With an established collaboration record working with Add Health, the team comprises collective expertise in biosocial frameworks, maternal and infant health, racialized health inequities, social stress, and biomarker analysis. The study has three aims: (1) identify how contextual early-life disadvantage (ELD) contributes to ra- cialized birth outcome ineq-uities through pre-pregnancy stress pathways; (2) identify how ELD shapes racial- ized inequities in post-childbirth maternal stress, mental health, and accelerated aging through pre-pregnancy stress pathways; and (3) determine the extent to which adolescent contextual risk and protective factors ex- plain or modify racialized maternal and birth outcome inequities, and the role of ELD. It focuses on social stress domains that are sensitive to racialized inequities and that carry implications for early-life interventions for achieving maternal and infant health equity. It is innovative by measuring and analyzing pre-pregnancy stress trajectories prospectively over the life course in a US-representative cohort with detailed social contextual data and new biomarkers of maternal stress and aging after childbirth.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $161,856 )
2025	2025	BOARD OF REGENTS OF THE NEVADA SYSTEM OF HIGHER ED	1664 N VIRGINIA ST # 285	RENO	NV	89557	WASHOE	USA	Child Health and Human Development Extramural Research	000	2	8/4/2025	NON-COMPETING CONTINUATION	$161,856
														Subtotal = $161,856

Issue Date FY: 2024 ( Subtotal = $176,255 )
2024	2024	BOARD OF REGENTS OF THE NEVADA SYSTEM OF HIGHER ED	1664 N VIRGINIA ST # 285	RENO	NV	89557	WASHOE	USA	Child Health and Human Development Extramural Research	000	1	8/12/2024	NEW	$176,255
														Subtotal = $176,255

Grand Total All Awards = $338,111

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Racialized inequities in birth outcomes and maternal health following childbirth: the role of maternal early-life disadvantage, adolescent contexts, and pre-pregnancy stress

Award Number: R21HD115143

ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/15/2024

PERIOD OF PERFORMANCE END DATE: 08/14/2026

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