Alexandra L. L Nowak

Dr. Alexandra L. L Nowak

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Research Focus & Metrics

Academic Career Length

7Years (2020-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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28 August 2021 in Western Journal of Nursing Research
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Journal Article
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CGCarmen Giurgescu
Carmen Giurgescu
MDMisra D.P.
Misra D.P.
JSJaime Slaughter-Acey
Jaime Slaughter-Acey
GSGillespie S.L.
Gillespie S.L.
Alexandra L. L NowakAlexandra L. L Nowak
Alexandra L. L Nowak
SPStemmer P.
Stemmer P.
African American women are more likely to experience preterm birth (<37 completed weeks gestation) compared with White women. African American women are also more likely to live in neighborhoods characterized as disadvantaged (i.e., exhibiting higher rates of vacant housing, poorer property conditions, and more litter and crime) and to experience racial discrimination compared with White women. These chronic stressors have been related to preterm birth (PTB) among African American women. This review focuses on potential stress-related pathways by which neighborhood disadvantage and racial discrimination increase the risk for PTB among African American women. Specifically, we propose cortisol, systemic inflammation, proteome and lipidome profiles, and telomere shortening as potential mediators linking these social determinants of health with PTB among African American women. Examination of these factors and the signaling pathways they contribute to will increase our knowledge of the effects of social determinants of health on PTB for African American women.

22 September 2021 in Western Journal of Nursing Research
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Journal Article
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CGCarmen Giurgescu
Carmen Giurgescu
AWAna Carolina Wong
Ana Carolina Wong
BRBrooke Rengers
Brooke Rengers
SVSarah Vaughan
Sarah Vaughan
Alexandra L. L NowakAlexandra L. L Nowak
Alexandra L. L Nowak
DMDawn P. Misra
Dawn P. Misra
We explored the associations among perceived stress, depressive symptoms, loneliness, and social support during the COVID-19 pandemic; and differences in perceived stress, depressive symptoms, and social support prior to the pandemic and during the pandemic among pregnant Black women. A sample of 33 pregnant Black women who participated in the Biosocial Impact on Black Births (BIBB) and were still pregnant in May–June 2020 were invited to complete an online survey about their experiences during the pandemic. Fifteen women responded very much or somewhat to experiencing stress and anxiety because of the COVID-19 pandemic. Eight women had CES-D scores ≥23, which have been correlated with depression diagnosis. Women who reported higher levels of loneliness during the COVID-19 pandemic also reported higher levels of perceived stress and depressive symptoms and lower levels of social support during the pandemic. Women who reported lower levels of social support during the pandemic also reported higher levels of perceived stress and depressive symptoms during the pandemic. There were no changes in perceived stress, depressive symptoms, or social support prior to the pandemic and during the pandemic. Clinicians should assess for signs of loneliness and depressive symptoms for pregnant women and offer recommendations for therapy and support groups.

5 May 2022 in Biological Research For Nursing
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Journal Article
Open access
Alexandra L. L NowakAlexandra L. L Nowak
Alexandra L. L Nowak
CACindy M. Anderson
Cindy M. Anderson
JFJodi L. Ford
Jodi L. Ford
Amy MackosAmy Mackos
Amy Mackos
JOJoyce Ellen Ohm
Joyce Ellen Ohm
CGCarmen Giurgescu
Carmen Giurgescu
Preterm birth (PTB; <37 weeks gestation) rates have increased for 5 of the last 6 consecutive years in the United States. These rates are particularly alarming for U.S. non-Hispanic Black women who give birth prematurely at 1.5 times the rate of non-Hispanic White women. Previous research suggests that psychological stress is associated with PTB in Black women. However, the biological pathways by which stress alters birth timing are not clear. We examined DNA methylation (DNAm) in peripheral blood leukocytes in 6 glucocorticoid, stress-related genes in 44 (22 PTB; 22 term birth) pregnant Black women. Four cytosine-phosphate-guanine (CpG) sites were identified as differentially methylated ( p < 0.05) between women with PTB and women with term births. The ability to identify stress-related biological markers that are associated with PTB among Black women would provide a critical step toward decreasing the PTB disparity among these women. Future studies should include larger sample sizes and gene expression analyses of the stress-related biological pathways to PTB.

16 January 2020 in Journal of Urban Health
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Journal Article
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Alexandra L. L NowakAlexandra L. L Nowak
Alexandra L. L Nowak
CGCarmen Giurgescu
Carmen Giurgescu
TTThomas N. Templin
Thomas N. Templin
RDRhonda K. Dailey
Rhonda K. Dailey
DMDawn P. Misra
Dawn P. Misra

31 May 2025 in Biological Research For Nursing
Verified
Journal Article
Closed access
KSKaren L. Saban
Karen L. Saban
LJLinda Janusek
Linda Janusek
PPPaula de la Pena
Paula de la Pena
SLSueyeon Lee
Sueyeon Lee
DTDina Tell
Dina Tell
JTJacquelyn Y. Taylor
Jacquelyn Y. Taylor
Background: DNA methylation (DNAm) is an epigenetic process of addition or reduction of methyl groups to genes that modify gene expression and can alter the physiological response to psychological stress. DNAm associated with psychological stress is malleable, making it a prime target for psychobehavioral interventions. Research is beginning to examine changes in DNAm in response to psychobehavioral interventions, such as mindfulness-based stress reduction, cognitive behavioral therapy, and yoga. A better understanding of the current evidence may provide direction for future research. Objective: The purpose of this scoping review is to summarize current studies, identify knowledge gaps, and make recommendations for further research related to examining alterations in DNAm in response to psychobehavioral interventions. Methods: A scoping review was conducted based on the methods recommended by Arksey and O’Malley (2005). Studies examining response of blood or saliva DNAm to psychobehavioral interventions in adult humans were reviewed. Results: Twenty-one studies met the inclusion criteria. Although many studies were inadequately powered, several reported differences in DNAm in response to a psychobehavioral intervention across a variety of genes, including genes related to stress and inflammation. However, the studies varied with respect to participant health status, type and duration of psychobehavioral interventions evaluated, biospecimens examined, and method of DNA analysis. Conclusions: The evaluation of DNAm in response to psychobehavioral interventions is a growing area of research. Future research is needed to address design limitations of existing investigations, evaluate the biological importance of observations, and link the DNAm response to physiological and psychological outcomes of the interventions.

Verified
Journal Article
Open access
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NSNadia Saadat
Nadia Saadat
FAFernando Aguate
Fernando Aguate
Alexandra L. L NowakAlexandra L. L Nowak
Alexandra L. L Nowak
SHSuzanne Hyer
Suzanne Hyer
ALAnna B. Lin
Anna B. Lin
CGCarmen Giurgescu
Carmen Giurgescu
Background/Objectives: Lipid metabolism plays an important role in maternal health and fetal development. There is a gap in the knowledge of how lipid metabolism changes during pregnancy for Black women who are at a higher risk of adverse outcomes. We hypothesized that the comprehensive lipidome profiles would show variation across pregnancy indicative of requirements during gestation and fetal development. Methods: Black women were recruited at prenatal clinics. Plasma samples were collected at 8–18 weeks (T1), 22–29 weeks (T2), and 30–36 weeks (T3) of pregnancy. Samples from 64 women who had term births (≥37 weeks gestation) were subjected to “shotgun” Orbitrap mass spectrometry. Mixed-effects models were used to quantify systematic changes and dimensionality reduction models were used to visualize patterns and identify reliable lipid signatures. Results: Total lipids and major lipid classes showed significant increases with the progression of pregnancy. Phospholipids and glycerolipids exhibited a gradual increase from T1 to T2 to T3, while sphingolipids and total sterol lipids displayed a more pronounced increase from T2 to T3. Acylcarnitines, hydroxy acylcarnitines, and Lyso phospholipid levels significantly decreased from T1 to T3. A deviation was that non-esterified fatty acids decreased from T1 to T2 and increased again from T2 to T3, suggestive of a potential role for these lipids during the later stages of pregnancy. The fatty acids showing this trend included key fatty acids—non-esterified Linoleic acid, Arachidonic acid, Alpha-linolenic acid, Eicosapentaenoic acid, Docosapentaenoic acid, and Docosahexaenoic acid. Conclusions: Mapping lipid patterns and identifying lipid signatures would help develop intervention strategies to reduce perinatal health disparities among pregnant Black women.