Researchers at Cal State Long Beach hope to better understand the link between stress, postpartum depression and early childhood development through a newly launched research program that will follow dozens of families from pregnancy to birth and beyond.
The new study is led by the university’s PRO-Health research program, which focuses on ways to improve health outcomes in underserved communities. This project will analyze what circumstances during pregnancy end up impacting the health and development of children, said Guido Urizar, director of PRO-Health and a CSULB health psychology professor.
“We’re really trying to get a thorough understanding of parents’ experiences,” Urizar said.
Factors such as parents’ upbringings, their experiences in society, their experiences with the health care system, and genetics will all be analyzed alongside how their bodies are responding to their environments, Urizar said.
For the first time, PRO-Health will also look at health disparities among different racial groups. While some past projects have examined racism and discrimination, those factors haven’t yet been measured specifically during pregnancy, according to Urizar.
The study will try to determine what makes it more likely for mothers to experience postpartum depression or birth complications and what factors can increase the likelihood of developmental delays.
Researchers are also trying to understand how they can improve outcomes—regardless of any genetic predispositions to complications—by connecting participating families with services.
A goal of the study is to design a health program that can decrease parents’ stress in order to reverse negative health outcomes, Urizar said.
Over the next year, Urizar hopes to enroll 125 families in the study, which will follow both parents and the child until six months after birth.
Unlike previous PRO-Health studies, fathers will be included, as long as each mother consents.
“There’s a lot of dads out there that have never been included in research,” Urizar said. “I think for us, the big question mark is, what’s the dad’s experiences? How’s that part of this puzzle piece? And we haven’t asked that before.”
Dads can earn up to $60 in gift cards for their participation and mothers will earn up to $100 in gift cards. The main requirement is that mothers must be between 10 and 24 weeks pregnant. Families will be visited twice during pregnancy and twice after giving birth.
The program is also using less invasive methods of data collection, something Urizar hopes will build trust with participants.
According to Urizar, people are often hesitant to participate in these types of studies, particularly within low-income communities. That’s because information about stress and the body’s response is often collected through blood draws, including ones from the umbilical cord by needle through the womb during later stages of pregnancy, Urizar said. This study, however, will use saliva and hair samples to measure stress levels.
For instance, by taking a small piece of a baby’s hair just a week after birth, researchers can test for the stress hormone cortisol and determine what the levels were during the mother’s third trimester.
One way health professionals investigate stress and its impacts is by looking at telomeres, which are caps on chromosomes that essentially protect DNA information. Urizar explained that telomeres shorten as we age. This is the reason why our hair turns white, our skin wrinkles and we face a greater risk for chronic diseases such as Alzheimer’s, heart disease, and cancer.
“Biologists used to think that whatever we were born with in terms of telomere length, that’s all we have, and as we get older, it just gets shorter and there’s nothing we can do about it,” Urizar said.
However, recently published research has indicated that if we engage in healthy behaviors— self-care, stress management, exercise and healthy eating—not only can we delay the shortening of our telomeres, but we can even increase the length, Urizar said.
This is particularly important when it comes to pregnancy because not all babies are born with the same telomere length, although it is unclear why, said Urizar. But with this study, hopefully contributing factors could come to light, whether it’s genetics, cortisol levels or parental experiences, he said.
Urizar said the idea for the study stemmed from a conversation with Gwendolyn Manning, who leads the city of Long Beach’s Black Infant Health program. She had recently learned about telomeres at a conference.
Because telomeres had previously only been examined through blood, PRO-Health had never assessed them, Urizar said.
“I came back to her and told ‘Hey, now we can get it through saliva. I’ll find some funding and we’ll do this project together,” said Urizar, who also serves on Black Infant Health’s advisory board.
After a year of hosting focus groups and incorporating feedback, the project was ready to launch and begin the family recruiting process.
Urizar acknowledged that this one project won’t be able to address all of the factors that can negatively impact mothers or their children, but similar research programs have been able to help families.
One past study showed that even women with an irregular pattern of cortisol (something that can be passed on to their babies), were able to regulate their cortisol levels by participating in the study’s stress-management program, which reduced birth complications and the baby’s cortisol levels, Urizar noted.
The study is supported by funding from the National Institute of Health as well as the National Science Foundation. The project also involves CSULB students at PRO-Health.
In the past 16 years, about 200 students have trained with PRO-Health, where they got the opportunity to attend advisory board meetings and meet with community leaders while helping to shape how projects are designed and communicated.
“What I really love about Long Beach is most of the students I teach, they grew up in Long Beach or surrounding areas, and they’re from the families that we serve,” Urizar said. “It’s really important for us to develop the next leaders . . . What sets them apart is they have the resilience and they also have the community experience going up in the community, but we want to put them in leadership positions where they can change the narrative there as well and be a voice.”