Protocol for the Emory University African American maternal stress and infant gut microbiome cohort study

• Type of Material: Article
• Authors: Patricia Brennan, Emory University; Anne Lang Dunlop, Emory University; Alicia Smith, Emory University; Michael Kramer, Emory University; Jennifer Mulle, Emory University; Elizabeth Corwin, Emory University
• Language: English
• Date: 2019-07-22
• Publisher: BMC (part of Springer Nature)
• Publication Version: Final Published Version
• Copyright Statement: © 2019 The Author(s).
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s12887-019-1630-4
• Title of Journal or Parent Work: BMC Pediatrics
• ISSN: 1471-2431
• Volume: 19
• Issue: 1
• Start Page: 246
• End Page: 246
• Grant/Funding Information: The grant provides funding for the data collection, analysis and interpretation of findings, and manuscript write ups.; PB and EC are funded as Principal Investigators; and AD, AS, MK, and JM are funded as Co-Investigators on this grant.; The cohort study described in this protocol is funded by National Institute on Minority Health and Health Disparities through Grant R01MD009746.
• Keywords: HEALTH; PRENATAL STRESS; Stress; DISPARITIES; Life Sciences & Biomedicine; Neurodevelopment; Science & Technology; IMPACT; BRAIN; OUTCOMES; COGNITIVE DELAY; Perinatal; Microbiome; Infant; BIRTH-WEIGHT; RISK-FACTORS; Pediatrics; IMMUNODEPRESSION
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Epidemiology; Psychology, Psychobiology

Abstract

Background: The microbial population of the human gut (the gut microbiome) is an integral cog in the bidirectional communication axis that exists between the gastrointestinal tract and the central nervous system. African American infants disproportionately experience multiple, overlapping vulnerabilities such as preterm birth and formula rather than breast feeding that may disrupt the development of the infant microbiome. African American infants also are more likely to have mothers affected by chronic stress both pre- and post-natally. Perhaps relatedly, African American offspring are disproportionately affected by neurodevelopmental delays. Taken together, these findings suggest that one important mechanism that may link prenatal and postnatal stress and African American infant brain development is the composition of the infant microbiome. Methods: In our ongoing longitudinal study, Maternal Stress and the Gut-Brain Axis in African American Infants (R01MD009746), we investigate associations between maternal prenatal and postnatal stress and the composition of the infant gut microbiome, in relation to cognitive and social-emotional development. We aim to recruit 300 African American mother-infant dyads, contingent on the mother's previous participation in an associated prenatal cohort study: Biobehavioral Determinants of the Microbiome and Preterm Birth in Black Women (R01NR014800). Following enrollment, we assess infants at 1-week, and 3-, 6-, 12-and 18-months to collect: standardized assessments of infant neurocognitive and social-emotional development; questionnaire measures of infant feeding and health; observational data on maternal-infant interactions; maternal reports of postnatal stress; blood and saliva samples to evaluate maternal and infant psychoneuroimmunologic (PNI) function; and infant stool samples to characterize acquisition and trajectory of gut microbiome composition. Genetic variants of the major histocompatibility complex that may influence gut microbiome composition are also being evaluated. Discussion: This rich data set will allow future consideration of risk and protective factors that influence neurodevelopment in African American infants who are exposed to varying levels of prenatal and early life stress. Evidence for a mechanistic role of the microbiome would provide a framework for future clinical evaluations of preventative interventions (e.g., probiotics, culturally-appropriate breastfeeding campaigns) that could potentially improve the health and development of African American children in infancy and across the lifespan.