Research Project
Mitigating the Effects of Structural Violence on Maternal Iron Status: A Randomized Controlled Pilot Study of Probiotic Supplementation in At-Risk Pregnant Black Women
- Principal Investigator
- Koenig, Mary Dawn
- Start Date
- 2017-09-23
- End Date
- 2022-06-30
- Funding Source
- Center for Health Equity Research Chicago
Abstract
Maternal iron deficiency (ID) and adverse maternal-infant health outcomes disproportionately affect Black women. Chronic exposure to structural violence can dysregulate a Black woman’s stress response promoting systemic inflammation. Stress-induced inflammation can negatively affect iron metabolism and promote ID that compromises the health of pregnant women and their infants – a phenomenon that may explain maternal-infant health disparities in Black women. Thus, interventions that can mitigate the physiologic effects of chronic stress have the potential to improve maternal-infant iron status that translates to positive maternal-infant health outcomes. There is evidence that the probiotic LP299v can reduce the adverse physiologic effects of stress and normalize iron metabolism although, this has not been tested in the context of pregnancy. We will conduct a double blinded placebo-controlled randomized pilot study to determine the feasibility and tolerability of daily oral LP299v supplementation (15 weeks gestation – delivery) in 20 pregnant Black women from marginalized neighborhoods of Chicago and explore the effect of daily oral LP299v vs. placebo on maternal stress response and iron status, infant iron status at delivery, and molecular mechanisms (maternal microbiome) that may mediate the effect of LP299v on maternal stress- and iron-related outcomes. Additionally, because health-related resources for pregnant women are limited in many of the marginalized neighborhoods of Chicago, we will also build a sustainable university-community partnership with the community organization New Moms to disseminate research findings and promote lifestyle and dietary approaches to mitigate the effects of chronic stress from structural violence for at-risk pregnant Black women in Chicago. The purpose is to determine the feasibility and tolerability of daily oral LP299v supplementation in pregnant Black women from marginalized neighborhoods of Chicago and to explore the effect of daily oral LP299v vs. placebo on maternal stress response and iron status, infant iron status at delivery, and molecular mechanisms that may mediate the effect of LP299v on maternal stress- and iron-related outcomes. The primary outcomes are the feasibility and tolerability of LP299v. The secondary outcomes include maternal stress response (i.e., cortisol) and iron status, infant iron status at delivery, and molecular mechanisms that may mediate the effect of LP299v on maternal stress- and iron-related outcomes (i.e., maternal stool microbiome, systemic inflammation and iron regulatory responses).