Low socioeconomic status (SES), typically associated with chronic psychosocial stress and poor early- life family environments, is a powerful predictor of adverse outcomes, including achievement deficits, delinquency, social emotional distress, substance abuse, mood disorders, and poorer overall physical health. Recent life course approaches to understanding future health emphasize the importance of early life influences, including the pre- and postnatal periods. That is, it has become increasingly recognized that maternal psychosocial stress-more common in low SES groups-can affect the development of fetal and infant systems critical for future health. Low SES has been associated with poor outcomes; however, low SES is not deterministic-not all born in low SES circumstances are burdened by illness. Biological measures of maternal perinatal functioning may help differentiate which women succumb to SES-related stress, an outcome that could pave the way for earlier and more targeted interventions, for them and their children. Two viable biological measures include: 1) allostatic load (AL), an index of multi-system physiology including endocrine (e.g. cortisol), immune (e.g., interleukin 6 (IL-6)) and other physiological systems that respond to psychosocial stress and 2) brain activation measured with functional magnetic resonance imaging (fMRI). AL and brain activation are strong candidate indices to consider when investigating the range of maternal functioning in situations of low SES. They are established measures in non-pregnant samples that go beyond self-report, and it is their biological, quantifiable nature that renders them promising as targets for intervention. With the research and training on this K99/R00 Pathway to Independence Award, I propose a novel approach to understanding SES-based compromised maternal well-being, which is so detrimental to children's future health. Specifically, using extant datasets (NICHD-nuMoM2b-001; 5R01MH092580-03A), predictive validity of AL will be established in pregnancy by examining SES and pregnancy AL in association with pregnancy outcomes such as gestational age at birth and birth weight (Aim 1). Additionally, the association of SES and pregnancy AL with maternal caregiving behavior at 4 months postpartum, controlling for postpartum AL, will be examined (Aim 2). In a new study, pregnancy AL will be examined in association with maternal caregiving behavior and brain activation to infant cry stimuli at 4 months postpartum in low SES women, controlling for postpartum AL (Aim 3). This award will provide critical training and mentorship during the K99 phase that will foster the transition to the R00 phase. The proposal includes a strong team of mentors and consultants from multiple disciplines, training visits to their respective labs, and coursework and formal seminars at Columbia University. In its training and research goals, this project represents a novel integration of maternal-child health and behavioral medicine research with cognitive neuroscience, aiming to provide new insights on biological targets for intervention with the overall goal of using intervention in early life to enhance future health.
Low socioeconomic status (SES) confers risk for poor health outcomes, representing a significant public health issue given current rising poverty rates for U.S. adults and children. The time around pregnancy is known to present significant hardship in particular for women with minimal resources. Taking an early origins of disease-risk approach, this grant proposes to target the biological mechanisms (i.e. allostatic load and brain activation) that may underlie poor outcomes in the time around pregnancy (i.e. pregnancy outcomes and maternal caregiving sensitivity in the early postpartum) with the overarching goal of offsetting the known deleterious consequences of lower SES and improving the health of offspring in this nation.
