Dr Grace Amedor (Medicine 2019) has led a University of Cambridge study that has found that stresses such as systemic racism and socioeconomic disadvantage may sensitise key processes in the body during pregnancy. The work undertaken while Dr Amedor was a student at Gonville & Caius College, and alongside senior author Fellow Professor Dino Giussani, helps to explain why black women and their babies face significantly higher rates of complication than white women.
These altered physiological processes may lead to higher rates of preeclampsia in black women, and higher rates of preterm birth and fetal growth restriction in black babies, compared to white women and their babies. Black women are nearly three times more likely to die during pregnancy, the study found.
Dr Amedor, now a resident doctor, added: “I wanted to investigate after I read that black women were much more likely to die in, or just after, pregnancy than white women. As a black woman myself that was scary to hear. I was surprised that although this disparity had been known for a long time, there was little research into the potential underlying physiological reasons.”
In a major review of published studies, the researchers looked at a range of processes that are vital in the body during pregnancy - including the control of inflammation, and blood flow to the developing fetus. They found these processes are often altered in ways linked to poorer pregnancy outcomes in black women, compared to white women.
These are not the result of genetic differences between black and white women. Instead, the results suggest that persistent socio-environmental stressors - known to have a measurable biological effect - may influence the body’s ability to function healthily during pregnancy.
Black women and their babies face significantly higher health risks during pregnancy and childbirth than white women. Black women in the UK are 2.7 times more likely to die during pregnancy compared with white women, and black babies are more than twice as likely to die before their first birthday as white babies.
Until now, the biological pathways that may help explain the link between socioeconomic inequalities and poorer pregnancy outcomes in black women have received little attention.
Dr Amedor, pictured, adds: “Pregnancy and childbirth put great stress on a woman’s body. Black women may experience additional strain due to factors including systemic racism, socioeconomic disadvantage and environmental stressors. During pregnancy, this strain may affect key biological processes in ways that increase the risk of conditions such as pre-eclampsia.”
Professor Giussani is a Director of Studies at Caius and Professor of Developmental Cardiovascular Physiology & Medicine at the University of Cambridge’s Department of Physiology Development & Neuroscience.
The full story is on the University of Cambridge website.
The report is published today in the journal Trends in Endocrinology & Metabolism.
