Exploring the Association of Maternal Socioeconomic Adversity, Epigenetics of Genes Regulating Fetal Glucocorticoid Intrauterine Exposure, and the Risk of Small for Gestational Age (SGA) in Term Infants Open Access

Albano, Martina (Spring 2024)

Permanent URL: https://etd.library.emory.edu/concern/etds/9w032466s?locale=en%255D
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Abstract

Socioeconomic status has been linked to adverse birth outcomes including reduced birth weight, and may have these effects because of impacts on maternal stress. This study examines the association between maternal socioeconomic adversity, epigenetic regulation of a stress response related pathway, and the risk of infants being born Small for Gestational Age (SGA). We hypothesize that socioeconomic adversity, quantified through a computed cumulative score that considered employment, tobacco use, marital status, household crowding, and education, may impact placental DNA methylation (DNAm) patterns of genes regulating fetal glucocorticoid exposure (HSD11B2, NR3C1, FKBP5), contributing to the occurrence of SGA. The findings revealed that, after adjusting for confounders, infants born to mothers with a higher cumulative socioeconomic adversity score have 2.53 (95% CI 1.30-4.93) times the odds of being classified as SGA compared to infants of mothers with a lower score. A significant association was also found between maternal socioeconomic adversity score and differential methylation at specific CpG sites within all three target genes. Significant DNAm patterns at CpG within the NR3C1 and FKBP5 genes were also associated with SGA risk. These findings hint at the potential for placental epigenetic regulation as a biological mechanism by which socioeconomic adversity influences birth outcomes. 

Table of Contents

Table of Contents

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Abstract

Title Page

Introduction…………………………………………………………………………….………….1

Methods……………………………………………………………………………………….…...5

Ethic Statement……………………………………………………………………………5

Study Population………………………………………………………………………..…5

Socioeconomic Adversity Measures…………………………………………………..…..6

DNA methylation (DNAm)………..…………………………………………………..…..7

Birth Outcome Classification..………..…………………………………………………...7

Covariates.………..……………………………..………………………………………...7

Analyses………..………..………………………………………………………………...8

Maternal Socioeconomic Adversity and Birth Outcomes…………………………8

Maternal Socioeconomic Adversity Score and DNAm at Candidate Genes……….9

DNAm and Birth Outcomes…………………………………………………….....9

Results ………..………..………………………………………………………………………...10

Sample Characteristics...…..……………………………………………………………..10

Bivariate Analyses…..……………………………………………………………….….. 13

Association Between Maternal Socioeconomic Adversity and Birth Outcomes………...14

Association Between Maternal Socioeconomic Adversity Score and DNAm……………15

Association Between DNAm and Birth Outcomes……………………………………….16

Discussion……………………………………………………….……………………………….18

Positionality statement …………………………………………………………………..23

Public Health Implications ………………………………………..……………………………..24

References …………………………………………………………..………….………………..26

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