| Autor: |
Clark J; Department of Environmental Sciences and Engineering, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA., Bulka CM; Department of Environmental Sciences and Engineering, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA., Martin CL; Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA., Roell K; Institute for Environmental Health Solutions, University of North Carolina, Chapel Hill, NC, USA., Santos HP; Institute for Environmental Health Solutions, University of North Carolina, Chapel Hill, NC, USA.; Biobehavioral Lab, School of Nursing, University of North Carolina, Chapel Hill, North Carolina, USA., O'Shea TM; Department of Pediatrics, Division of Neonatal-Perinatal Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA., Smeester L; Department of Environmental Sciences and Engineering, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.; Institute for Environmental Health Solutions, University of North Carolina, Chapel Hill, NC, USA., Fry R; Department of Environmental Sciences and Engineering, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.; Institute for Environmental Health Solutions, University of North Carolina, Chapel Hill, NC, USA.; Curriculum in Toxicology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA., Dhingra R; Department of Environmental Sciences and Engineering, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.; Institute for Environmental Health Solutions, University of North Carolina, Chapel Hill, NC, USA. |
| Abstrakt: |
Social determinants of health (SDoH) are defined as the conditions in which people are born, grow, live, work, and age. The distribution of these conditions is influenced by underlying structural factors and may be linked to adverse pregnancy outcomes through epigenetic modifications of gestational tissues. A promising modification is epigenetic gestational age (eGA), which captures 'biological' age at birth. Measuring eGA in placenta, an organ critical for foetal development, may provide information about how SDoH 'get under the skin' during pregnancy to influence birth outcomes and ethnic/racial disparities. We examined relationships of placental eGA with sociodemographic factors, smoking, and two key clinical outcomes: Apgar scores and NICU length of stay. Using the Robust Placental Clock, we estimated eGA for placental samples from the Extremely Low Gestational Age Newborns cohort (N = 408). Regression modelling revealed smoking during pregnancy was associated with placental eGA acceleration (i.e., eGA higher than chronologic gestational age). This association differed by maternal race: among infants born to mothers racialized as Black, we observed greater eGA acceleration (+0.89 week, 95% CI: 0.38, 1.40) as compared to those racialized as white (+0.27 week, 95% CI: -0.06, 0.59). Placental eGA acceleration was also correlated with shorter NICU lengths of stay, but only among infants born to mothers racialized as Black (-0.08 d/week-eGA, 95% CI: -0.12, -0.05). Together, these observed associations suggest that interpretations of epigenetic gestational aging may be tissue-specific. |
