Baylor to research environmental health disparities in pregnancy outcomes

Baylor College of Medicine has received a grant from the National Institutes of Health to fund a new Maternal and Infant Environmental Health Riskscape (MIEHR) Research Center. Baylor will receive $7.1 million over five years and is one of only three sites in the country selected as a Center of Excellence for environmental health disparities research by the National Institute of Minority and Health Disparities. The goal of this new center is to identify key drivers of racial disparities in pregnancy outcomes, such as preterm birth and hypertensive disorders during pregnancy.

The center will study chemical and non-chemical exposures at the individual and neighborhood level from the biological, physical and social environments - collectively referred to as the riskscape - that affect maternal and infant health. Communities of color experience a riskscape burdened not only by social stressors but also by chemical exposures, in part because their neighborhoods are often located closer to industrial and hazardous waste sites.

"There's a 50 percent higher risk for preterm birth among Black women than among non-Hispanic white women, but the reason for that disparity is not clear," said Dr. Elaine Symanski, principal investigator of the center and professor in the Center for Precision Environmental Health at Baylor. "Trying to tease out whether the impact of chemical and non-chemical stressors is different between these two groups is critically important if we are to improve birth outcomes for mothers and their babies."

One study will utilize PeriBank, which includes data from women who give birth at Baylor College of Medicine affiliated hospitals. Dr. Kjersti Aagaard, MIEHR co-investigator and professor of obstetrics and gynecology at Baylor and Texas Children's hospital, led the development of PeriBank.

"We are incredibly grateful for the decade-plus of resources and support from Texas Children's and Baylor College of Medicine in building the infrastructure necessary to enable this study and providing key data suggesting a link between environmental exposures and preterm birth," Aagaard said.

A second study will prospectively enroll women around the time of delivery and develop classifiers for preterm birth in both Black and white mothers using information on chemical exposures, neighborhood-level social stressors and biological features such as cell-free RNA in the maternal circulation.

"If we can identify the top predictors of preterm birth, we may be able to use those factors to intervene and mitigate risk for this adverse pregnancy outcome in the future," Symanski said.

Baylor researchers will partner with Texas Southern University, one of the largest historically black universities in the country, on research and community engagement activities of the MIEHR Research Center. The center will work closely with populations affected by health disparities to get feedback on how to enhance and maximize impact of the research. Distinguished Professor of Urban Planning and Environmental Policy at Texas Southern University, Dr. Robert Bullard, will serve as deputy director and lead these efforts at TSU. Bullard is widely acknowledged as the father of environmental justice.

"Research linking pollution, race and health formed the foundation of the environmental justice movement - beginning with my 1979 Houston waste study," Bullard said. "Our community engagement work is grounded in a health equity and racial justice lens, with the ultimate goal of using science and research findings to address environmental health disparities and building resilience in communities disproportionately affected by pollution."

"The current COVID-19 pandemic has highlighted that substantial health disparities remain. Some of the factors responsible for higher COVID-19 morbidity and mortality risk in people of color are likely the same risk factors for adverse pregnancy outcomes," Symanski said. "This study will enable us to begin to address these disparities in a meaningful way."

The center also aims to train the next generation of translational environmental health researchers. A pilot project program will provide support for junior investigators from health disparity populations to increase the capacity for future research targeting environmental health disparities. The program will be open to Baylor and TSU investigators.

"Texas Southern University is excited about the partnership with Baylor College of Medicine, and we look forward to the results of the studies conducted through the MIEHR Research Center," said TSU Provost and Vice President of Academic Affairs and Research Dr. Kendall T. Harris. "This critical work in the community is in alignment with TSU's designation as a special-purpose institution for urban programming and research."

"Recent events in our country have highlighted the deep-rooted issues of structural racism in the nation," Symanski said. "The center is one of the ways Baylor College of Medicine is seeking to address health issues within this broader context of equity."

This research is funded by the National Institute on Minority Health and Health Disparities grant number 1P50MD015496-01.

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