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Author Notes:

Corresponding Author: Elizabeth J. Corwin, Email : ejcorwi@emory.edu

The authors are grateful to the women who generously agree to participate in this important study.

EJC, CJH, BP, TDR, JM, and ALD were involved in the conception of the study and the drafting of the protocol. EJC, CJH, BP, CCH, TDR, JM, and ALD were all involved in the development, design, refinement, and implementation of the study.

All authors have contributed to the preparation of this manuscript and have read and given final approval for its submission and publication.

This study was reviewed for ethical and safety considerations by the Internal Review Board (IRB00068441) of both Emory University and Grady Memorial Hospital and approved by both Boards.

Written consent is obtained from all participant at the initial recruitment, prior to the collection of data.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The authors declare that they have no competing interests.


Research Funding:

This study was funded by a grant from the National Institutes of Health, National Institute of Nursing Research (R01NR014800)


  • Chronic stress
  • Health disparity
  • Microbiome
  • Pregnancy
  • Preterm birth

Protocol for the Emory University African American Vaginal, Oral, and Gut Microbiome in Pregnancy Cohort Study (includes Corrected pdf)


Journal Title:

BMC Pregnancy and Childbirth


Volume 17, Number 1


, Pages 161-161

Type of Work:

Article | Final Publisher PDF


BACKGROUND: Adverse birth and neonatal outcomes disproportionately affect African American women and infants compared to those of other races/ethnicities. While significant research has sought to identify underlying factors contributing to these disparities, current understanding remains limited, constraining prevention, early diagnosis, and treatment. With the development of next generation sequencing techniques, the contribution of the vaginal microbiome to adverse maternal and neonatal outcomes has come under consideration. However, most microbiome in pregnancy studies include few African American women, do not consider the potential contribution of non-vaginal microbiome sites, and do not consider the effects of sociodemographic or behavioral factors on the microbiome. METHODS: We conceived our on-going, 5-year longitudinal study, Biobehavioral Determinants of the Microbiome and Preterm Birth in Black Women, as an intra-race study to enable the investigation of risk and protective factors within the disparate group. We aim to recruit over 500 pregnant African American women, enrolling them into the study at 8-14 weeks of pregnancy. Participants will be asked to complete questionnaires and provide oral, vaginal, and gut microbiome samples at enrollment and again at 24-30 weeks. Chart review will be used to identify pregnancy outcomes, infections, treatments, and complications. DNA will be extracted from the microbiome samples and sequencing of the V3 and V4 regions of the 16S rRNA gene will be conducted. Processing and mapping will be completed with QIIME and operational taxonomic units (OTUs) will be mapped to Greengenes version 13_8. Community state types (CSTs) and diversity measures at each site and time will be identified and considered in light of demographic, psychosocial, clinical, and biobehavioral variables. DISCUSSION: This rich data set will allow future consideration of risk and protective factors, between and within groups of women, providing the opportunity to uncover the roots of the persistent health disparity experienced by African American families.

Copyright information:

© The Author(s). 2017

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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