The Association of Perceived Stress, Glucocorticoids Receptors, and Corticotropin-Releasing Hormone Gene Expression During Pregnancy.

The preterm birth rate and the maternal mortality rate are 1.6 and 2.6 times higher for Black women than for White women, respectively, in the United States. This disproportionate difference in maternal health outcomes is a notable health inequity. The purpose of this study was to evaluate the influence of perceived stress, and glucocorticoid receptors (GR) on histone acetylation (HAT) of the corticotropin-releasing hormone (CRH) gene between non-Hispanic Black and non-Hispanic White women in their second trimester of pregnancy. This study used a cross-sectional design to analyze secondary, deidentified data including peripheral blood monocyte cells, from a prior study. The study sample consisted of 32 non-Hispanic Black women and 73 non-Hispanic White women from the parent study. A four-step hierarchical linear regression analysis was used to analyze the influence of race, perceived stress, and GR on the HAT of the CRH gene. The hierarchical linear regression analysis found that race, perceived stress, and GR significantly predicted the HAT of the CRH. GR explained 41.33% of the variation in HAT CRH of the gene, and age plus race explained an additional 3.56% of the variation in HAT CRH of the gene. The findings of this study suggest that perceived stress and GR among young Black women were associated with higher levels of HAT of the CRH gene, which may contribute to adverse pregnancy outcomes such as preeclampsia and preterm birth. These findings highlight stress-related factors contributing to maternal morbidity, and the need for a comprehensive approach to improving prenatal healthcare.