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Southern Center on Environmentally Driven Disparities in Birth Outcomes

Duke University

The central mission of the Southern Center on Environmentally-Driven Disparities in Birth Outcomes is to determine how environmental, social, and host factors jointly contribute to health disparities in birth outcomes. Although it is widely agreed that maternal and fetal health and well-being are determined by multiple forces, surprisingly little is known about the interactions of those forces. For example, elevated environmental exposures often occur in communities facing multiple social stressors like deteriorating housing, inadequate access to health care, poor schools, high unemployment, high crime, and high poverty — all of which may compound the effects of environmental exposures. This phenomenon is especially severe for low income and minority pregnant mothers, with significant health implications for the fetuses they carry. In addition, despite an emerging consensus that numerous gene- environment interactions determine maternal and child health, we know little about how genetic and environmental factors combine to promote or prevent adverse outcomes. This center seeks to disentangle these complicated effects by combining rapidly evolving methods in spatial statistics, genetics, and proteomics, in complementary human and animal models of birth outcomes.

Low birthweight (LBW), preterm birth (PTB), and fetal growth restriction (FGR) all exhibit documented disparities across subpopulations. Survivors of LBW and PTB are at significant risk for both short-term neonatal morbidity as well as long-term disabilities, including respiratory distress syndrome, variable heart rate, cerebral ventriculomegaly, cerebral palsy, mental retardation, blindness, deafness, learning disabilities, behavioral disabilities, and motor impairment. Of similar importance is the impact of lower birth weight on increased risk of diabetes, obesity, cardiovascular disease and other health problems in adulthood. Thus, understanding, and eventually intervening, to prevent these adverse birth outcomes is of critical importance to the overall health of the nation.

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