TY - GEN A1 - Scholaske, Laura A1 - Lindner-Matthes, Denise A1 - Kurt, Medlin A1 - Duman, Elif Aysimi A1 - Sahbaz, C. A1 - Spallek, Jacob A1 - Entringer, Sonja T1 - Intergenerational transmission of health disparities among Turkish-origin residents in Germany: role of maternal stress and stress biology during pregnancy. A study protocol T2 - European Journal of Public Health N2 - Background:Turkish-origin immigrants constitute one of the biggest migration groups in Germany where they exhibit higher levels of social disadvantage when compared to the majority population. Research has elucidated the underlying mechanisms by which social disadvantage is biologically embedded to impact health over the lifespan. However, relatively little is known about how its effects are transmitted across generations. Aims of the study: To elucidate the effects of maternal migration status and socioeconomic status on stress-related maternal-placental-foetal (MPF) biological processes across gestation and on subsequent infant birth and health outcomes. Methods: We are conducting a longitudinal cohort study of N = 450 child-mother dyads with serial measures across gestation and birth through the first year of life. Our proposed study population will include approximately equal numbers of Turkish-origin women in Germany, German women in Germany, Turkish women living in Turkey and their offspring. Study visits are conducted from the second trimester of pregnancy to the end of the first year of life to assess maternal socio-economic and migration-related information, psychological well-being, nutrition, medical risk variables, and MPF stress biology markers from maternal blood and saliva samples. Infant anthropometric measures, developmental outcomes and stress markers in saliva are assessed throughout the first year of life. Analyses: We will test specific hypotheses regarding the association between migration background, socioeconomic status and MPF stress biology. We will furthermore quantify the association of maternal migration background- and social disadvantage-related MPF stress biology measures on pregnancy and child health outcomes. Discussion: This is the first study on foetal programming of health disparities with a focus on Turkish-origin women in Germany. The significance and impact of this study derives from the importance of achieving a better understanding of underlying mechanisms that alter disease vulnerability in minority and disadvantaged populations. KW - maternal stress KW - pregnancy KW - health disparity Y1 - 2018 U6 - https://doi.org/10.1093/eurpub/cky048.044 SN - 1464-360X SN - 1101-1262 N1 - 1st World Congress on Migration, Ethnicity, Race and Health VL - 28 IS - Suppl. 1 SP - S. 126 ER - TY - GEN A1 - Spallek, Jacob A1 - Scholaske, Laura A1 - Duman, Elif Aysimi A1 - Razum, Oliver A1 - Entringer, Sonja T1 - Association of maternal migrant background with inflammation during pregnancy – results of a birth cohort study in Germany T2 - Brain, Behavior, and Immunity N2 - Background Health disparities in children of immigrants are prevalent from birth and are hypothesized to – in part – emerge as a biological consequence of migration’s unfavorable social and psychological sequelae. The aim of this study was to examine whether maternal migrant background is associated with inflammation during pregnancy - a key pathway by which maternal states and conditions during pregnancy may influence fetal development and subsequent pregnancy, birth, and child developmental and health outcomes. Material and Methods Data was available from 126 pregnant women who participated in a population based multi-site prospective birth cohort study in Bielefeld and Berlin, Germany. The study included two study visits in mid- and late pregnancy. At each visit, a composite maternal pro-inflammatory score was derived from circulating levels of plasma inflammatory markers (IL-6, CRP). Migrant background was defined by country of origin of participants and their parents’ (Turkey or other) and generation status (1st or 2nd generation). We applied hierarchical linear models (HLM) in order to quantify the relationship between different migrant background variables and inflammation during pregnancy after adjustment for potential confounders (including socioeconomic status). Results Migrant background was significantly associated with inflammation during pregnancy. When compared to women without migrant background, levels of inflammation were increased in 1) pregnant women with migrant background in general (B = 0.35, SE = 0.12, p < .01); 2) 1st (B = 0.28, SE = 0.15, p < .10) and 2nd generation (B = 0.40, SE = 0.15, p < .01); 3) women with a Turkish migrant background (B = 0.28, SE = 0.14, p < .10) and women with another migrant background (B = 0.42, SE = 0.15, p <.01); and 4) 2nd generation Turkish origin women (B = 0.38, SE = 0.20, p <.10), 1st generation women with other migrant background (B = 0.44, SE = 0.26, p <.10), and 2nd generation women with other migrant background (B=0.43, SE = 0.17, p <.05). Discussion Our findings support a role for maternal inflammation as a pathway of intergenerational transmission of migration-related health inequalities, suggest that the effect seems to persist in 2nd generation immigrants, and highlight the need for future research and targeted interventions in this context. KW - Transmission of Health Inequalities KW - Stress biology KW - Immigrants KW - Inflammation Y1 - 2021 U6 - https://doi.org/10.1016/j.bbi.2021.06.010 SN - 1090-2139 VL - Vol. 96 SP - 271 EP - 278 ER - TY - GEN A1 - Entringer, Sonja A1 - Scholaske, Laura A1 - Kurt, Medlin A1 - Duman, Elif Aysimi A1 - Adam, Emma K. A1 - Razum, Oliver A1 - Spallek, Jacob T1 - Diurnal cortisol variation during pregnancy in Turkish origin and non-migrant women in a German birth cohort study T2 - Journal of Psychosomatic Research N2 - Background Immigrants from Turkey experience health disadvantages relative to non-immigrant populations in Germany that are manifest from the earliest stages of the lifespan onwards and are perpetuated across generations. Chronic stress and perturbations of stress-responsive physiological systems, including the hypothalamus-pituitary-adrenal (HPA)-axis, are believed to in part mediate this relationship. Cortisol plays an important role in the association between maternal stress during pregnancy and many pregnancy-, birth- and offspring-related outcomes. We therefore examined whether maternal migrant background is associated with diurnal cortisol variation during pregnancy. Methods 109 pregnant women (incl. n = 32 Turkish origin women) that participated in a multi-site prospective cohort study in Germany collected saliva samples across the day on two consecutive days around 24 and 32 weeks gestation. Hierarchical linear models were applied to quantify associations between migrant background and diurnal cortisol variation across pregnancy. Results Women of Turkish origin exhibited a significantly lower cortisol awakening response (CAR) and a flatter diurnal cortisol slope (DCS) compared to non-migrant women after adjusting for household income. These relationships between migrant status and diurnal cortisol variation were mainly driven by 2nd generation migrants. Discussion A potential HPA axis dysregulation of Turkish-origin pregnant women may contribute to the intergenerational transmission of health disadvantages in this group. KW - cortisol variation KW - pregnancy KW - Turkish origin KW - birth cohort study KW - Germany Y1 - 2022 UR - https://www.sciencedirect.com/science/article/abs/pii/S0022399922003051 U6 - https://doi.org/10.1016/j.jpsychores.2022.111020 SN - 0022-3999 VL - 162 SP - 1 EP - 10 ER - TY - GEN A1 - Scholaske, Laura A1 - Spallek, Jacob A1 - Duman, Elif Aysimi A1 - Adam, Emma K. A1 - Razum, Oliver A1 - Entringer, Sonja T1 - Increased Levels of Psychological Stress and Alterations in Stress Biology during Pregnancy among Women of Turkish-Origin in Germany T2 - Psychoneuroendocrinology N2 - Background People of Turkish origin constitute one of the biggest migrant groups in Germany. They have an increased risk to develop stress-related health disadvantages, and this risk is also prevalent in the offspring generation from early ages on. We have conducted a multi-site prospective cohort study to examine the role of stress and stress biology in this intergenerational perpetuation of health disparities. Methods 140 pregnant women (33 of Turkish origin) participated in a prospective cohort study with two study visits during pregnancy and one after birth (T1: 20-25 weeks of gestation, T2: 30-35 weeks of gestation, T3: four weeks after birth). At T1 and T2, women completed the Perceived Stress Scale and Center for Epidemiologic Studies Depression Scale and collected saliva samples after awakening, 30 minutes after awakening, and in the evening, and venous blood samples were collected for analysis of CRP and IL-6 concentrations. Results Multilevel models showed that Turkish-origin women exhibited higher levels of perceived stress and depressive symptoms, had increased inflammatory levels (Spallek et al., 2021), a blunted cortisol awakening response and flatter diurnal cortisol slope during pregnancy compared to non-migrant women after adjustment for socioeconomic factors.Some of the effects were mainly driven by 2nd generation migrants. Conclusions Increased levels of psychosocial stress and stress-related biological alterations among Turkish-origin pregnant women may contribute to the intergenerational transmission of health disadvantages in this group. Y1 - 2023 UR - https://www.sciencedirect.com/science/article/pii/S0306453023002470?via%3Dihub U6 - https://doi.org/10.1016/j.psyneuen.2023.106269 SN - 0306-4530 VL - 153 PB - ScienceDirect ER -