Profiling plasma-derived extracellular vesicles as predictive biomarkers of adverse pregnancy outcomes in black women Kobe Alexandria Abney

Format:

Book

Thesis/Dissertation

Author/Creator:

Abney, Kobe Alexandria, author.

Contributor:

University of Pennsylvania. Pharmacology., degree granting institution.

Language:

English

Subjects (All):

Molecular biology.

Obstetrics.

Womens studies.

Black studies.

Ethnic studies.

0307.

0380.

0631.

0453.

0325.

Local Subjects:

Molecular biology.

Obstetrics.

Womens studies.

Black studies.

Ethnic studies.

0307.

0380.

0631.

0453.

0325.

Genre:

Academic theses

Physical Description:

1 online resource (132 pages)

Contained In:

Dissertations Abstracts International 87-12A

Place of Publication:

Ann Arbor : ProQuest Dissertations and Theses, 2026

Language Note:

English

Summary:

Black women in the U.S. experience maternal mortality and morbidity nearly three to four times the rate of White women. These disparities persist after socioeconomic status, education, and maternal behavior are controlled for, implicating the biological embedding of structural racism - through mechanisms such as chronic inflammation and oxidative stress. Notably, these mechanisms contribute to placental dysfunction and adverse pregnancy outcomes, which typically go undetected until late in pregnancy. Identifying molecular signatures of placental dysfunction during early pregnancy (11-15 weeks) could enable better risk assessment and targeted intervention before irreversible damage occurs. Circulating extracellular vesicles (EVs) serve as promising, minimally invasive biomarkers that can capture molecular alterations in placental and maternal cellular functions in real-time. Throughout pregnancy, both maternal and placental cells release EVs that carry functional nucleic acids, proteins, and metabolites into maternal circulation as a form of maternal-fetal communication. Despite growing interest in EVs as biomarkers of pregnancy complications, no study has examined whether EV cargo differs by race or reflect signatures underlying placental dysfunction and adverse pregnancy outcomes. This dissertation addresses this gap. In Chapter 1, we determined which EV subtype captures biologically meaningful signatures relating to mitochondrial and placental function. Multi-omics revealed that large EVs (lEVs), relative to small EVs, were enriched with cargo reflecting systemic mitochondrial activity, oxygen sensing, endocrine signaling, and vascular adaptation. These findings established the rationale for focusing on lEVs in subsequent analyses. In Chapter 2, we investigated race-associated lEV signatures between Black and White women with preeclampsia, gestational hypertension, preterm birth, and fetal growth restriction and tested the functional capacity of EVs to alter trophoblast hormone production. lEVs from Black women were characterized by a lower concentration, fewer mitochondrial DNA copies, immune activation signatures, and the capacity to increase hormone production relative to lEVs from White women. This work represents the first study to address how race, as a proxy of psychosocial stress, alters EV biology in the context of adverse pregnancy outcomes. We provide a framework that investigates how the lived experiences of Black women become biologically embedded during pregnancy to inform clinically translatable approaches for addressing the Black maternal health crisis

Notes:

Source: Dissertations Abstracts International, Volume: 87-12, Section: A.

Advisors: Simmons, Rebecca A. Committee members: Conine, Colin; Jurado, Kellie; Brenner, Jacob; Parry, Samuel

Ph.D. University of Pennsylvania 2026

Vendor supplied data

Local Notes:

School code: 0175

ISBN:

9798247973362

Access Restriction:

Restricted for use by site license