2/5 The Cumulative Risk of Substance Exposure and Early Life Adversity on Child Health Development and Outcomes

2/5 物质暴露和早年不幸对儿童健康发展和结果的累积风险

• 批准号: 10199299
• 负责人: Amy J Elliott
• 金额: $ 19.38万
• 依托单位: AVERA MCKENNAN
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2021-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10199299
• 关键词: Affect; American Indians; Child Health; Collection; Country; Data; Development; Devices; Electrocardiogram; Electroencephalography; Ethics; European; Gestational Diabetes; Goals; Health Personnel; Health Promotion; Home environment; Hospitals; Incidence; Investigation; Knowledge; Lead; Maternal Health; Maternal Mortality; Mental Depression; Monitor; Motivation; Outcome; Polysomnography; Population; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnant Women; Reporting; Research Support; Risk; Risk Factors; Schedule; Sleep; Sleep disturbances; United States; Variant; Visit; Women' s Health; base; cost effective; early life adversity; ethnic minority population; experience; health disparity; health equity; high risk; improved; maternal outcome; maternal risk; modifiable risk; monitoring device; mortality; pandemic disease; perinatal period; pregnancy hypertension; racial and ethnic; severe maternal morbidity; sleep health; study population; telehealth; tool; wearable device

Project Summary/Abstract In the United States, rates of maternal mortality and severe maternal morbidities are higher than almost all European countries and provide one of the starkest examples of women's health disparities. One modifiable risk factor associated with multiple maternal complications during pregnancy is sleep health. Poor sleep health in the perinatal period has been found to be associated with several conditions known to increase the risk for maternal health complications and mortality, such as gestational diabetes, pregnancy-induced hypertension, preeclampsia, and depression. Additionally, greater risk incidence of poor sleep reports occurs among racial/ethnic minorities. Nonetheless, sleep health changes are often regarded by pregnant women and healthcare providers as “normal” and there is a lack of understanding on what constitutes normal/abnormal variations in sleep health during pregnancy. This knowledge gap in part, derives from the lack of cost-effective, easy-to use and reliable sleep monitoring devices that can be used in the home. The current proposal will investigate the feasibility of using wearable devices that acquires 2-lead EEG and ECG to monitor sleep during pregnancy and specifically in an American Indian population at high risk for poor maternal outcome. Our hypotheses are that: 1) we will have a positive experience in home delivery and collection of devices in the general study population across all racial ethic groups and 2) we will collect a minimum of 75% usable data for the overnight recordings, which will allow us to acquire and derive sleep health metrics using a validated AI platform. Our goal is to establish if wearable solutions would provide viable alternatives to sleep lab assessments and more invasive in-home monitor solutions. This investigation is particularly relevant given the current pandemic, which has affected the ability and motivation for pregnant women to schedule visits for hospital-based studies, making telehealth solutions a preferable solution. In conclusion, sleep has been shown to be a modifiable risk factor and the availability of practical tools to assess sleep health in the home environment will afford the opportunity to improve maternal health, as outlined in the IMPROVE initiative goals, to support research on how to mitigate preventable maternal mortality, decrease severe maternal morbidity, and promote health equity in the U.S.

项目概要/摘要 在美国，孕产妇死亡率和严重孕产妇发病率几乎高于 所有欧洲国家，都是妇女健康差异最明显的例子之一。一 与妊娠期多种孕产妇并发症相关的可改变危险因素是睡眠健康。 研究发现，围产期睡眠健康状况不佳与多种疾病有关 已知会增加孕产妇健康并发症和死亡的风险，例如妊娠期 糖尿病、妊娠高血压、先兆子痫和抑郁症。另外，风险更大 睡眠质量不佳的报告发生在少数种族/族裔中。尽管如此，睡眠健康 孕妇和医疗保健提供者通常将变化视为“正常”，并且存在 对怀孕期间睡眠健康的正常/异常变化缺乏了解。 这种知识差距部分源于缺乏具有成本效益、易于使用和可靠的睡眠 可在家中使用的监控设备。目前的提案将调查可行性 使用可采集 2 导联脑电图和心电图的可穿戴设备来监测怀孕期间的睡眠，以及 特别是在产妇结局不佳的高风险美洲印第安人群体中。我们的假设 是： 1) 我们将在送货上门和收集设备方面获得积极的体验 研究所有种族群体的人口，2) 我们将收集至少 75% 的可用数据 过夜记录，这将使我们能够使用 经过验证的人工智能平台。 我们的目标是确定可穿戴解决方案是否能为睡眠实验室评估提供可行的替代方案 以及更具侵入性的家庭监控解决方案。鉴于当前的情况，这项调查尤为重要 大流行影响了孕妇安排就诊的能力和动机 基于医院的研究使远程医疗解决方案成为更好的解决方案。 总之，睡眠已被证明是一个可改变的风险因素，并且实用工具的可用性 评估家庭环境中的睡眠健康将为改善孕产妇健康提供机会， 正如 IMPROVE 倡议目标所述，支持研究如何减轻可预防的 降低孕产妇死亡率、降低严重孕产妇发病率并促进美国的健康公平