Race and preterm birth--the case for epigenetic inquiry

Area of Science:

• Reproductive Health
• Genetics
• Public Health

Background:

• Significant racial disparities exist in preterm birth rates and infant mortality between African American and White families in the United States.
• African American infants experience preterm birth at rates over 18%, compared to less than 12% for White infants, leading to a doubled risk of infant mortality.
• Traditional explanations like socioeconomic status, prenatal care, and behavioral factors do not fully account for these disparities.

Purpose of the Study:

• To explore the underlying biological mechanisms contributing to racial disparities in birth outcomes.
• To propose epigenetic inquiry as a critical next step in understanding these disparities.
• To identify potential avenues for future interventions to improve birth outcomes for African American women and infants.

Main Methods:

• This commentary reviews existing epidemiologic data and proposes a life-course conceptual model.
• The proposed model includes mechanisms of early-life programming and cumulative physiological wear and tear (weathering).
• The authors advocate for the application of epigenetic research methods to investigate these biological pathways.

Main Results:

• Existing data suggest life-course factors significantly impact pregnancy outcomes.
• The biological mechanisms linking these factors to disparities remain poorly understood.
• Epigenetics provides a promising framework to investigate these poorly understood biological mechanisms.

Conclusions:

• Racial disparities in preterm birth and infant mortality are a critical public health issue.
• Epigenetic research is essential to uncover the biological basis of these disparities.
• Understanding these mechanisms through epigenetics may lead to effective interventions and improved birth outcomes.