Identification of preventable causes of preterm delivery, a primary determinant of infant morbidity and mortality, is an important but elusive goal. In order to address promising hypotheses concerning the role of iron, zinc and folate, we will conduct a cohort and nested case-control study of preterm delivery, building upon the ongoing study of Pregnancy, Infection and Nutrition (PIN Study). A food frequency questionnaire and biological markers of nutrient status are being collected between 24 and 29 weeks gestation. In the current funding period, we expect to enroll a cohort of 2,300 women (approximately half Black, half White), with 300 preterm delivery cases and 450 randomly selected controls, which will be expanded to 3,050 in the proposed study for a total of 410 preterm cases and 615 controls. Diet questionnaire data will be used to construct indices of iron, zinc, and folate intake for the three months preceding the survey. Blood samples will be used to construct indices of iron, zinc, and folate intake for the three months preceding the survey. Blood samples will be assayed for transferrin receptor concentrations and serum ferritin concentration as indicators of iron status, and plasma and red cell folate levels, with information on hemoglobin levels and hemocrit obtained from medical records. We plan to conduct an intensive diet validation study of 130 women, evenly divided between Black and White women. These women will be asked to provide three 24-hour recall on randomly selected days in each trimester, and will complete food frequency questionnaires addressing each trimester and one addressing the entire pregnancy period. Other risk factors which may act as confounders for the micronutrients of interest, include genital tract infections, vitamin C, tobacco use, cocaine use, and psychosocial stress. We will analyze the relationship between dietary intake of iron, zinc, and folate, as well as biological markers of iron and folate, in relation to the risk of preterm delivery using logistic regression. We will address subsets of preterm delivery due to preterm labor, preterm PROM, and medical indications, and examine patterns of association among Black and White women. Given the size of the study, the combination of questionnaire data and biological markers of nutrient status, and the careful assessment of potential confounding factors, this study promises to markedly advance our knowledge of the potential role of iron, zinc, and folate in the etiology of preterm delivery.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
2R01HD028684-05
Application #
2693289
Study Section
Special Emphasis Panel (ZRG4-HPD (13))
Program Officer
Spong, Catherine
Project Start
1995-01-01
Project End
2001-12-31
Budget Start
1999-01-01
Budget End
1999-12-31
Support Year
5
Fiscal Year
1999
Total Cost
Indirect Cost
Name
University of North Carolina Chapel Hill
Department
Miscellaneous
Type
Schools of Medicine
DUNS #
078861598
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Tian, Yan; Holzman, Claudia; Siega-Riz, Anna M et al. (2016) Maternal Serum 25-Hydroxyvitamin D Concentrations during Pregnancy and Infant Birthweight for Gestational Age: a Three-Cohort Study. Paediatr Perinat Epidemiol 30:124-33
Martin, Chantel L; Siega-Riz, Anna Maria; Sotres-Alvarez, Daniela et al. (2016) Maternal Dietary Patterns are Associated with Lower Levels of Cardiometabolic Markers during Pregnancy. Paediatr Perinat Epidemiol 30:246-55
Martin, Chantel L; Sotres-Alvarez, Daniela; Siega-Riz, Anna Maria (2015) Maternal Dietary Patterns during the Second Trimester Are Associated with Preterm Birth. J Nutr 145:1857-64
Harmon, Quaker E; Engel, Stephanie M; Wu, Michael C et al. (2014) Polymorphisms in inflammatory genes are associated with term small for gestational age and preeclampsia. Am J Reprod Immunol 71:472-84
Lenhart, Patricia M; Nguyen, Thutrang; Wise, Alison et al. (2014) Adrenomedullin signaling pathway polymorphisms and adverse pregnancy outcomes. Am J Perinatol 31:327-34
Stuebe, Alison M; Wise, Alison; Nguyen, Thutrang et al. (2014) Maternal genotype and gestational diabetes. Am J Perinatol 31:69-76
Harmon, Quaker E; Engel, Stephanie M; Olshan, Andrew F et al. (2013) Association of polymorphisms in natural killer cell-related genes with preterm birth. Am J Epidemiol 178:1208-18
McLean, Mamie; Hines, Rachel; Polinkovsky, Margaret et al. (2012) Type of skin incision and wound complications in the obese parturient. Am J Perinatol 29:301-6
Ghosh, Joyee; Herring, Amy H; Siega-Riz, Anna Maria (2011) Bayesian variable selection for latent class models. Biometrics 67:917-25
Laraia, Barbara A; Siega-Riz, Anna Maria; Gundersen, Craig (2010) Household food insecurity is associated with self-reported pregravid weight status, gestational weight gain, and pregnancy complications. J Am Diet Assoc 110:692-701

Showing the most recent 10 out of 61 publications