Social determinants of telomere lengths among low-income, ethnically diverse pregnant women

Telomere length is a biomarker of cellular aging and predictor of chronic disease. The association between psychosocial stressors and shortened telomere length suggests telomeres may mediate relationships between chronic stress and adverse health outcomes. However, little is known about regulation of telomere biology during pregnancy. Our pilot study examined whether conditions of chronic adversity are associated with shortened telomeres among low-income pregnant women. We recruited 72 pregnant women who obtained health care at San Francisco General Hospital in San Francisco, California which predominantly serves patients with no health insurance. We administered a survey to participants during mid-pregnancy about their socioeconomic status, perceptions of neighborhood conditions, and relative social status. A blood sample was collected during labor, and telomere length was measured from DNA by quantitative PCR. The majority of participants were foreign-born, Spanish-speaking, Latinas (67%). Age, race/ethnicity, country of origin, education, and neighborhood perceptions were independently associated with telomere length in multivariate models. Shorter telomeres were found in older women, Latinas, particularly those who were Mexican-born, and those with higher education. There was a dose-response relationship between higher educational attainment and shorter telomeres (p-trend = 0.006). Women who chose an affirmative or neutral response to the statement, “I would move from this neighborhood if I could”, had shorter telomeres (p=0.02) than women who disagreed with this statement. This is one of the first studies to examine predictors of telomeres during pregnancy. Future work should confirm these findings and examine their implications on fetal development.