Alexis Dunn Amore's additional information
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Alexis Dunn Amore PhD, CNM is a clinical associate professor at NYU Rory Meyers College of Nursing. She is committed to advancing the health of those most vulnerable. Her clinical practice, teaching, research and service are focused on dismantling perinatal health disparities, addressing racism and bias in midwifery and nursing education, and developing initiatives to address the root causes of maternal mortality. Her work has improved the health of thousands of women through research and clinical practice as well as advocacy efforts on the state and national level. She is passionate about the community and works in collaboration with several community organizations to develop timely and innovative strategies to address disparities in health outcomes for black women during pregnancy, as well as initiatives to build social support and resilience in the birth community.
Amore has received active funding for her research in the past from the National Institutes of Health, and the American College of Nurse Midwives. She is currently funded as a Co-Investigator on a R01 study funded by NIH/NINR entitled “Biologic Mechanisms of Labor Dysfunction: A systems Biology approach“ for which she oversees the community advisory board and leads sessions with them to support the research process. She has published in a variety of journals including the Journal of Midwifery and Women’s Health, Biological Research for Nursing, and BMC Pregnancy and Childbirth. Additionally, she actively disseminates health-related information through mainstream and social media outlets and has been featured on NPR radio as well as television broadcasts for Fox 5 Atlanta.
Prior to joining the faculty at NYU Meyers, Amore worked as a tenure track assistant professor at the Nell Hodgson Woodruff School of Nursing at Emory University. She also worked as a certified nurse midwife at the Atlanta Birth Center. Additionally, she has several years working as a nurse midwife in a variety of hospital based and community settings.
She is a fellow in the American College of Nurse Midwives and the American Academy of Nursing in which she actively serves on several committees. She is also current Vice-President for the American College of Nurse Midwives through which she serves to uplift the profession of midwifery and to sure access of care people across the reproductive spectrum.
Amore earned her Bachelors of Science degree in Nursing in 2005 from the University of Tennessee, Knoxville. She earned her MSN Midwifery in 2009, post masters certificate in nursing education in 2010, and her PhD in Nursing in 2017 from Emory University.
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PhD, Nursing-Emory University (2017)Post-Master’s Certificate, Nursing Education-Emory University (2010)MSN, Nursing-Emory University (2009)BSN, Nursing-University of Tennessee Knoxville (2005)
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MidwiferyNursing education
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American Academy of NursingAmerican Nurses AssociationAmerican College of Nurse Midwives
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Faculty Honors Awards
Research Article of the Year, American College of Nurse Midwives (2022)Fellow (FAAN), American Academy of Nursing (2021)Emerging Leader in Health and Medicine Fellow, National Academy of Science and Medicine (2020)Excellence in Teaching Award, American College of Nurse Midwives (2020)Fellow (FACNM), American College of Nurse Midwives (2020)Nurse of the Year for Nursing Education, March of Dimes (2018) -
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Publications
Complement Activation during Early Pregnancy and Clinical Predictors of Preterm Birth in African American Women
AbstractDunn, A. B., Dunlop, A. L., Miller, A. H., Hogue, C. J., Crofton, J. M., & Corwin, E. J. (2019). Journal of Perinatal and Neonatal Nursing, 33(4), E15-E26. 10.1097/JPN.0000000000000443AbstractComplement activation is essential for select physiologic processes during pregnancy; however, excess activation has been associated with an increased risk for preterm birth (PTB). African American (AA) women experience disproportionately higher rates of inflammation-Associated PTB than other groups of women; thus, the purpose of this study was to explore the relationship between complement activation and perinatal outcomes among AA women. A plasma sample was collected between 8 and 14 weeks' gestation from a cohort of healthy AA women (N = 144) enrolled in a larger PTB cohort study. Medical record review was conducted to collect information on clinical factors (cervical length, health behaviors, gestational age at delivery). Multiple regression analysis was used to explore the relationships between complement marker (C3a/Bb) concentrations and the outcomes of interest after adjusting for baseline characteristics. C3a/Bb concentrations were not significant predictors of the gestational age at delivery, cervical length, or behavioral risk factors for PTB in this sample. Complement markers may not influence pregnancy outcomes among AA women in the same way as in predominantly white populations; however, more studies are needed to define complement dysregulation and the relationship with outcomes among AA women.Through the Microbial Looking Glass: Premature Labor, Preeclampsia, and Gestational Diabetes: A Scoping Review
AbstractDunn, A. B., Hanson, L., Vandevusse, L., & Leslie, S. (2019). Journal of Perinatal and Neonatal Nursing, 33(1), 35-51. 10.1097/JPN.0000000000000375AbstractThe influence of microbial factors on adverse perinatal outcomes has become the focal point of recent investigations, with particular interest in the role of the microbiome and probiotic interventions. The purpose of this scoping review was to identify and critique the most recent evidence about these factors as they relate to pregnancies complicated by preeclampsia (PEC), preterm birth (PTB), and gestational diabetes mellitus (GDM). Four databases (PubMed, EMBASE, Web of Science, and Cochrane) were searched for articles published in English in the last 10 years with the concepts of the microbiome, probiotics, and PEC, PTB, or GDM. Forty-nine articles were eligible for full-text review. Five articles were excluded, leaving 44 articles that met all the eligibility criteria. The relationships between the microbiome and the risk for PEC, PTB, and GDM are not fully elucidated, although probiotic interventions seem beneficial in decreasing PEC and GDM risk. Probiotic interventions targeting bacterial vaginosis and elimination of infection in women at risk for PTB appear to be beneficial. More research is needed to understand the contributions of the microbiome to adverse perinatal outcomes. Probiotic interventions appear to be effective in reducing risk for select outcomes.Antepartum Care of Women Who Are Obese During Pregnancy: Systematic Review of the Current Evidence
AbstractCarlson, N. S., Leslie, S. L., & Dunn, A. (2018). Journal of Midwifery and Women’s Health, 63(3), 259-272. 10.1111/jmwh.12758AbstractIntroduction: Nearly 40% of US women of childbearing age are obese. Obesity during pregnancy is associated with multiple risks for both the woman and fetus, yet clinicians often feel unprepared to provide optimal antepartum care for this group of women. We collected and reviewed current evidence concerning antepartum care of women who are obese during pregnancy. Methods: We conducted a systematic review using PRISMA guidelines. Current evidence relating to the pregnancy care of women with a prepregnancy body mass index of 30kg/m2 or higher was identified using MEDLINE databases via PubMed, Embase, and Web of Science Core Collection between January 2012 and February 2018. Results: A total of 354 records were located after database searches, of which 63 met inclusion criteria. Topic areas for of included studies were: pregnancy risk and outcomes related to obesity, communication between women and health care providers, gestational weight gain and activity/diet, diabetic disorders, hypertensive disorders, obstructive sleep apnea, mental health, pregnancy imaging and measurement, late antepartum care, and preparation for labor and birth. Discussion: Midwives and other health care providers can provide better antepartum care to women who are obese during pregnancy by incorporating evidence from the most current clinical investigations.The Maternal Infant Microbiome: Considerations for Labor and Birth
AbstractDunn, A. B., Jordan, S., Baker, B. J., & Carlson, N. S. (2017). MCN The American Journal of Maternal Child Nursing, 42(6), 318-325. 10.1097/NMC.0000000000000373AbstractThe human microbiome plays a role in maintaining health, but is also thought to attenuate and exacerbate risk factors for adverse maternal-child health outcomes. The development of the microbiome begins in utero; however, factors related to the labor and birth environment have been shown to influence the initial colonization process of the newborn microbiome. This "seeding" or transfer of microbes from the mother to newborn may serve as an early inoculation process with implications for the long-term health outcomes of newborns. Studies have shown that there are distinct differences in the microbiome profiles of newborns born vaginally compared with those born by cesarean. Antibiotic exposure has been shown to alter the microbial profiles of women and may influence the gut microbial profiles of their newborns. Considering that the first major microbial colonization occurs at birth, it is essential that labor and birth nurses be aware of factors that may alter the composition of the microbiome during the labor and birth process. The implications of various activities and factors unique to the labor and birth environment that may influence the microbiome of women and newborns during the labor and birth process (e.g., route of birth, antibiotic use, nursing procedures) are presented with a focus on the role of labor nurses and the potential influence of nursing activities on this process.Maternal-Child Microbiome: Specimen Collection, Storage, and Implications for Research and Practice
AbstractJordan, S., Baker, B., Dunn, A., Edwards, S., Ferranti, E., Mutic, A. D., Yang, I., & Rodriguez, J. (2017). Nursing Research, 66(2), 175-183. 10.1097/NNR.0000000000000201AbstractBackground The maternal microbiome is a key contributor to the development and outcomes of pregnancy and the health status of both mother and infant. Significant advances are occurring in the science of the maternal and child microbiome and hold promise in improving outcomes related to pregnancy complications, child development, and chronic health conditions of mother and child. Objectives The purpose of this study was to review site-specific considerations in the collection and storage of maternal and child microbiome samples and its implications for nursing research and practice. Approach Microbiome sampling protocols were reviewed and synthesized. Precautions across sampling protocols were also noted. Results Oral, vaginal, gut, placental, and breast milk are viable sources for sampling the maternal and/or child microbiome. Prior to sampling, special considerations need to be addressed related to various factors including current medications, health status, and hygiene practices. Proper storage of samples will avoid degradation of cellular and DNA structures vital for analysis. Discussion Changes in the microbiome throughout the perinatal, postpartum, and childhood periods are dramatic and significant to outcomes of the pregnancy and the long-term health of mother and child. Proper sampling techniques are required to produce reliable results from which evidence-based practice recommendations will be built. Ethical and practical issues surrounding study design and protocol development must also be considered when researching vulnerable groups such as pregnant women and infants. Nurses hold the responsibility to both perform the research and to translate findings from microbiome investigations for clinical use.The Microbiome and Complement Activation: A Mechanistic Model for Preterm Birth
AbstractDunn, A. B., Dunlop, A. L., Hogue, C. J., Miller, A., & Corwin, E. J. (2017). Biological Research for Nursing, 19(3), 295-307. 10.1177/1099800416687648AbstractPreterm birth (PTB, <37 completed weeks’ gestation) is one of the leading obstetrical problems in the United States, affecting approximately one of every nine births. Even more concerning are the persistent racial disparities in PTB, with particularly high rates among African Americans. There are several recognized pathophysiologic pathways to PTB, including infection and/or exaggerated systemic or local inflammation. Intrauterine infection is a causal factor linked to PTB thought to result most commonly from inflammatory processes triggered by microbial invasion of bacteria ascending from the vaginal microbiome. Trials to treat various infections have shown limited efficacy in reducing PTB risk, suggesting that other complex mechanisms, including those associated with inflammation, may be involved in the relationship between microbes, infection, and PTB. The complement system, a key mediator of the inflammatory response, is an innate defense mechanism involved in both normal physiologic processes that occur during pregnancy implantation and processes that promote the elimination of pathogenic microbes. Recent research has demonstrated an association between this system and PTB. The purpose of this article is to present a mechanistic model of inflammation-associated PTB, which hypothesizes a relationship between the microbiome and dysregulation of the complement system. Exploring the relationships between the microbial environment and complement biomarkers may elucidate a potentially modifiable biological pathway to PTB.Maternal Microbiome and Pregnancy Outcomes That Impact Infant Health: A Review
AbstractDunlop, A. L., Mulle, J. G., Ferranti, E. P., Edwards, S., Dunn, A. B., & Corwin, E. J. (2015). Advances in Neonatal Care, 15(6), 377-385. 10.1097/ANC.0000000000000218AbstractThe maternal microbiome is recognized as a key determinant of a range of important maternal and child health outcomes, and together with perinatal factors influences the infant microbiome. This article provides a summary review of research investigating (1) the role of the maternal microbiome in pregnancy outcomes known to adversely influence neonatal and infant health, including preterm birth, cardiometabolic complications of pregnancy such as preeclampsia and gestational diabetes, and excessive gestational weight gain; (2) factors with an established link to adverse pregnancy outcomes that are known to influence the composition of the maternal microbiome; and (3) strategies for promoting a healthy maternal microbiome, recognizing that much more research is needed in this area.Perineal Injury During Childbirth Increases Risk of Postpartum Depressive Symptoms and Inflammatory Markers
AbstractDunn, A. B., Paul, S., Ware, L. Z., & Corwin, E. J. (2015). Journal of Midwifery and Women’s Health, 60(4), 428-436. 10.1111/jmwh.12294AbstractIntroduction: Perineal lacerations during childbirth affect more than 65% of women in the United States. Little attention has been given to the long-term biologic consequences associated with perineal lacerations or possible associations with postpartum mental health. In this article, we describe the results of a study that explored inflammatory cytokines in women who reported perineal lacerations during childbirth and the relationship with stress and depressive symptoms during the first 6 months postpartum. Methods: A repeated measures design was used to explore the relationship between varying degrees of perineal lacerations, inflammatory cytokines, postpartum stress, and depressive symptoms in 153 women over 6 months. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS), and maternal stress was measured using the Perceived Stress Scale. Plasma was analyzed for proinflammatory (tumor necrosis factor alpha, interleukin 6 (IL-6), interleukin-1 beta, interferon gamma) and anti-inflammatory (interleukin 10) cytokines. Levels of cytokines were compared between women with or without varying degrees of injury. Results: A relationship was identified between symptoms of depression and a second-degree or more severe perineal laceration starting at one month postpartum (P = .04) and continuing through 3 months postpartum (P = .03). Similarly, stress symptoms were higher at 3 months postpartum (P = .02). Markers of inflammation were significantly higher among this group, with IL-6 increased at 2 weeks postpartum (P = .02) and remaining elevated through 2 months postpartum (P = .003); there were also significant differences in pro- to anti-inflammatory cytokine ratios out to 6 months postpartum. Regression analysis indicated that second-degree or more severe lacerations accounted for 5.9% of the variance in EPDS score at one month postpartum (P = .024, F = 2.865, t = 2.127), increasing substantially when the one month stress score was included as well. Discussion: This study suggests that perineal lacerations, inflammation, stress, and depressed mood are associated; however, more research is needed to elucidate the actual relationship between inflammation and mental health in women who experience such injuries.