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

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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.