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Gaining a deeper understanding of social determinants of preterm birth by integrating multi-omics data
Xiumei Hong1, Tami R Bartell2, Xiaobin Wang3,4
1Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. xhong3@jhu.edu.
Insights
Social determinants of health, like maternal stress, contribute to preterm birth (PTB) disparities in Black women. Integrating multi-omics with SDH research is crucial for understanding and addressing these persistent health inequities.
Area of Science:
- Reproductive Health
- Social Epidemiology
- Genomics and Epigenetics
Background:
- Persistent high rates of preterm birth (PTB) and significant Black-White disparities in the US.
- Social determinants of health (SDH), particularly maternal stress, are implicated in PTB disparities.
- Existing research suggests neither genetics nor environment alone explains the Black-White PTB gap.
Purpose of the Study:
- To review the role of SDH and maternal stress in the Black-White PTB disparity.
- To explore the biological embedding of these disparities through epigenetics and gene-environment interactions.
- To highlight the potential of integrating multi-omics data with SDH in future research.
Main Methods:
- Literature review focusing on PTB, SDH, maternal stress, epigenetics, and multi-omics.
- Analysis of existing studies on gene-environment interactions and their impact on PTB.
- Synthesis of findings to identify knowledge gaps and future research directions.
Main Results:
- SDH and maternal stress are critical factors contributing to the Black-White PTB disparity.
- Epigenetic mechanisms and gene-environment interactions play a role in mediating the effects of stress on PTB.
- Neither genetic factors nor environmental exposures alone fully explain the observed disparities.
Conclusions:
- Integrating multi-omics data with SDH in prospective birth cohort studies is essential for a comprehensive understanding of PTB disparities.
- Future research should prioritize high-risk populations, particularly Black women, to address long-standing health inequities.
- Advancements in biomedical science offer unprecedented opportunities to tackle PTB disparities.
Abstract:
In the US, high rates of preterm birth (PTB) and profound Black-White disparities in PTB have persisted for decades. This review focuses on the role of social determinants of health (SDH), with an emphasis on maternal stress, in PTB disparity and biological embedding. It covers: (1) PTB disparity in US Black women and possible contributors; (2) the role of SDH, highlighting maternal stress, in the persistent racial disparity of PTB; (3) epigenetics at the interface between genes and environment; (4) the role of the genome in modifying maternal stress-PTB associations; (5) recent advances in multi-omics studies of PTB; and (6) future perspectives on integrating multi-omics with SDH to elucidate the Black-White disparity in PTB. Available studies have indicated that neither environmental exposures nor genetics alone can adequately explain the Black-White PTB disparity. Preliminary yet promising findings of epigenetic and gene-environment interaction studies underscore the value of integrating SDH with multi-omics in prospective birth cohort studies, especially among high-risk Black women. In an era of rapid advancements in biomedical sciences and technologies and a growing number of prospective birth cohort studies, we have unprecedented opportunities to advance this field and finally address the long history of health disparities in PTB. IMPACT: This review provides an overview of social determinants of health (SDH) with a focus on maternal stress and its role on Black-White disparity in preterm birth (PTB). It summarizes the available literature on the interplay of maternal stress with key biological layers (e.g., individual genome and epigenome in response to environmental stressors) and significant knowledge gaps. It offers perspectives that such knowledge may provide deeper insight into how SDH affects PTB and why some women are more vulnerable than others and underscores the critical need for integrating SDH with multi-omics in prospective birth cohort studies, especially among high-risk Black women.
