Tampa, FL (Nov. 15, 2004) -- University of South Florida researchers want to know whether helping black pregnant women cope with psychological and social stresses will decrease their disproportionately higher rates of premature birth.    "Pre-term birth is a very serious problem in the United States – the leading cause of death among infants born without congenital defects. And, premature infants who survive face a high risk of lifelong disabilities," said perinatal epidemiologist Wendy Nembhard, PhD, MPH, an assistant professor at the USF College of Public Health. "We're interested in determining whether we can decrease the higher incidence of pre-term deliveries among black women."

Wendy Nembhard, PhD, MPH

Dr. Nembhard is the lead investigator for Pride & Joy: The Tampa Pregnancy and Health Study, a community-based study sponsored by the Centers for Disease Control and Prevention and the Association of Teachers of Preventive Medicine. The study seeks to enroll 700 Hillsborough County black women, ages 18 to 44, who are 8 to 18 weeks pregnant.

Infants born to black women are more than twice as likely to be too small (less than 3-1/2 pounds) and one-and-a-half times more likely to be delivered too early, Dr. Nembhard said. This disparity in birth outcomes between black and white women remains even when studies take into account the socioeconomic status, education and prenatal care of the mothers, she added. "The gap is not improving, and the increased risk for black women has not been explained."

The USF researchers will explore the role of psychosocial stress in premature births. Their goal is to find a way to predict, and possibly help reduce, prematurity.

"It's designed to be a highly interactive program in a nurturing environment. The idea is to help the women identify recurrent stresses in their lives and find the tools that work best for them in alleviating the stress," Dr. Nembhard said. "Some stresses can be avoided and others cannot, but the individual's reaction to stress can be managed."

The USF study will also examine the link between premature birth and stress-related hormones, including corticotropin-releasing hormone (CRH). The amount of CRH rises rapidly in the bloodstream just before normal labor, preparing a woman for full-term delivery. Research suggests that if CRH is chronically elevated too early in the pregnancy, it may trigger premature delivery.

About 250 volunteers in the Tampa Pregnancy and Health Study will be given blood tests measuring levels of CRH and other stress-related hormones four times during their pregnancy. Half of these volunteers will be attending the stress management program, while the other half will not. "We want to determine whether women as a result of the stress management program actually do have lower levels of these stress-related hormones, and if the lower hormone levels are associated with lower rates of pre-term pregnancy," Dr. Nembhard said.

If the research confirms the connection, she said "we may be able to lower the risk of pre-term delivery with interventions to reduce stress during pregnancy."