Maternal age is a well-documented factor for preterm birth, with women ages 40 and older at the greatest risk. But as the saying goes, age is just a number.

“Chronological age (age based on a birth year) assumes that individuals age at the same rate, but we know that is not true thanks to advances in research,” says Carmen Giurgescu, a world-renowned maternal health expert and associate dean of research at UCF’s College of Nursing.

UCF College of Nursing Associate Dean of Research Carmen Giurgescu is a world-renowned maternal health expert.

“Black women of the same age as white women have a higher risk for preterm birth,” she says.

Giurgescu is leading a new five-year $3.3 million study, funded by the National Institutes of Health, to examine the epigenetic, or biological, age of pregnant Black women and its potential in determining risk for preterm birth.

In the U.S., the rate of preterm birth — giving birth at 37 weeks or earlier — among Black women is 50% higher than white or Hispanic women. Preterm birth is also the leading cause of infant mortality among Black infants.

By examining DNA methylation of Black pregnant women, researchers will be able to determine the biological age based on biomarkers.

The innovative study is also examining whether social stressors are changing the DNA of Black pregnant women, influencing their biological age and accelerating aging.

Previous studies have shown that Black women are more likely to experience chronic stress due to social stressors of racial discrimination, and neighborhood disorder and crime. These factors are related to preterm birth among Black women.

“Black women at a younger age may be at higher risk because of these chronic stressors that they’re exposed to and that may be influencing their biological age,” she says.

Giurgescu’s new study is based on her previous NIH-funded research, in which studies followed approximately 600 Black women through pregnancy from Detroit and Columbus, Ohio. Using saliva and blood samples already collected, researchers will conduct DNA methylation to be able to estimate biological age — an innovative approach to looking at preterm birth and one that will address gaps in current research.

The new study could pave the way for a precision healthcare approach, one that considers an individual’s genetics, environment and lifestyle, to guide decisions for maternal healthcare.

“Preterm birth is a complex syndrome,” Giurgescu says. “In the future, it may be that one way to assess risk and predict preterm birth will be to consider biological age and social determinants of health of women.”

For Giurgescu, the ultimate goal of her research is to reduce disparities and improve birth outcomes among Black women.

Early in her clinical career as a labor and delivery nurse and later as women’s health care nurse practitioner, she witnessed the negative health outcomes for Black women and their babies and realized that stress has an influence on preterm birth. At that time, it was a novel idea.

Now for two decades and counting, she has pioneered research in the field of examining social determinants of health and preterm birth for Black women. But, she says, “there’s still a lot to do.”