Psychological Stress and Hepcidin: Link to Birth Outcomes

Principal Investigators

Dates: 4/1/12 – 3/31/13

Abstract: Hepcidin, a newly identified regulator of iron homeostasis, blocks gastrointestinal absorption of iron, thereby lowering circulating levels and availability to the placenta and fetus. Although it is known that increased inflammation up-regulates hepcidin, it is not known how psychological stress affects hepcidin. African American women have the highest rates of preterm birth, low birth weight, and iron deficiency. Iron affects placental development, which is important for maintaining pregnancy and transfer of essential nutrients to the fetus during gestation. In our pilot study of 20 pregnant African Americans, we found moderate, significant correlations between perceived racial discrimination (r=0.6 p<.05) and perceived crime (r=0.6 p,.05) and hepcidin levels. Although not statistically significant, we also found moderate correlations between perceived physical disorder, perceived social disorder, coping and hepcidin levels (range r=0.33-0.60). A larger, more diverse sample is needed to determine the relationship between other measures of psychological stress and hepcidin. In the innovative longitudinal correlational study, we are the first to link psychological stress to hepcidin in humans. We enrolled 66 pregnant African Americans. Data was collected two times: 16-22 and 26-32 weeks. Psychological stress was measured by perceived neighborhood environment, perceived racial discrimination, personal resources (optimism, self-esteem, coping), and emotional stress responses (distress, anxiety, depressive symptoms). Hepcidin will be measured by biological markers in blood. The specific aims are:

Primary Aim 1. Determine if psychological stress is correlated with hepcidin levels during pregnancy.

Hypothesis. At any time point during pregnancy, increased psychological stress will be correlated with increasing hepcidin levels.

Exploratory Aim 2. Determine whether hepcidin levels are associated with negative birth outcomes, including pre-term birth (<37 weeks gestation) and low birth weight (<2500 grams).

Hypothesis. At any time point during pregnancy, increased hepcidin levels will be associated with negative birth outcomes.

MNRS Seed – IMidwest Nursing Research Society