Doctoral Dissertation Research: Cultural-Biological Research on Stress and Gestational Age

Oregon State University, Corvallis OR

Investigators

Abstract

The research supported by this award will investigate the relationship between culture and biology through the lens of maternal stress and pregnancy outcomes, particularly pre-terms births. Previous research has shown that some of the variability in rates of premature birth and thus the health of newborn babies can be attributed to social and cultural factors. However, little is known about the mechanisms that connect poverty, racism, and other social determinants with gestational age at delivery. Oregon State University anthropology doctoral student, Holly Horan, with the supervision of Dr. Melissa Cheyney, will investigate the possibility that maternal stress may be one linking factor. This is an important problem because globally, an estimated 15 million infants are born preterm each year. Preterm delivery, defined as a live-birth before 37 weeks gestational age, is a leading cause of death among children under five years of age, and is associated with lifelong, chronic health issues for those children who survive delivery. The research will be carried out in Puerto Rico which has the highest rate of preterm birth in the entire U.S. jurisdiction. Furthermore, the most common epidemiological variables linked to preterm birth (such as maternal age, smoking, maternal education, first trimester pre-natal care, and lacking health insurance) in other places do not account for the rate in Puerto Rico. Recently, however, researchers have suggested a new avenue of inquiry: a possible relationship between maternal stress and early delivery, although to date, findings from these studies have been equivocal due to methodological constraints. Therefore, Horan will refine stress research methods in order to more reliably characterize and examine relationships between cultural and biological factors. She will collect data with a mix of social and biological methods, including: participant observation; administering the Puerto Rican version of the Cohen Perceived Stress Scale (PSS) and the Revised Prenatal Distress Questionnaire (RPDQ); hair cortisol concentration (HCC) sampling; and semi-structured postpartum exit interviews. She will identify cultural models of maternal stress using exploratory, semi-structured interviews with an initial 25 participants. The PSS, RPDQ, and HCCs will be assessed at three points during gestation (10 to 12 weeks, 22 to 24 weeks, and 34 to 36 weeks) in an additional 100 women in order to identify trends in stress experiences and hormones by trimester. An exit interview will be conducted between four to eight weeks postpartum and a fourth and final hair cortisol sample will be collected from these 100 participants. Hair cortisol concentrations (HCCs) will be used to investigate the utility of a simple, non-invasive cortisol measure as a longitudinal, biological proxy of maternal stress experiences. This study has the potential to result in a more comprehensive understanding of the social and structural etiologies associated with maternal stress and poor maternal and infant health outcomes. These findings will be of interest to policy makers as well as to researchers who seek to understand the connections between society, culture, and biology.