At the forefront of psychoneuroimmunology in pregnancy: Implications for racial disparities in birth outcomes: PART 2: Biological mechanisms

Neurosci Biobehav Rev. 2020 Oct;117:327-333. doi: 10.1016/j.neubiorev.2019.03.010. Epub 2019 Mar 15.


As reviewed in Part 1 of this two part review, birth prior to full term is a substantial public health issue. In the US, ˜400,000 babies per year are born preterm (< 37 weeks), while>1 million are early term (37-386/7 weeks) and remarkable racial disparities in shortened gestation are observed among African Americans as compared to Whites. Biomechanisms linking stressor exposures with birth outcomes are increasingly being explicated. The current paper reviews the mechanistic role of maternal biological functioning in the link between behavioral exposures and birth outcomes. These include the inter-related roles of neuroendocrine function, inflammatory regulation, biological aging, and the microbiome. An integrative approach which addresses both behavioral and biological factors within the same study, carefully considers the role of race/ethnicity, and rigorously defines birth outcomes (e.g., spontaneous versus medically-indicated and inclusive of early term birth) is needed to move research in this field toward better mechanistic understanding and clinical application.

Keywords: Birth outcomes; Inflammation; Microbiome; Neuroendocrine; Pregnancy; Psychoneuroimmunology; Racial disparities; Social genomics; Stress; Transcriptomics.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • African Americans
  • Ethnic Groups
  • European Continental Ancestry Group*
  • Female
  • Humans
  • Infant, Newborn
  • Pregnancy
  • Psychoneuroimmunology*