| Abstrakt: |
Preterm birth (PTB) has a complex etiology that includes genetic heritability, lifestyle and health, socioeconomic status, and psychosocial stress. Racial disparities in pregnancy outcomes are reported in many countries, but an especially marked contrast is evident in the United States. Because of the size of the problem, considerable research has investigated the involvement of genetic and social factors. However, race is a social construct and evidence suggests that in the United States the effect of Black race on PTB is environmental, not genetic. This derives since stress accumulates throughout a lifetime and across generations leading to a large accumulated allostatic load that is mediated by epigenetic mechanisms. Epigenetic mechanisms can however be reversed and therein lies future hope. |
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