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

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 这是所有欧洲国家妇女健康差距最明显的例子之一。一 与怀孕期间多种产妇并发症相关的可改变的风险因素是睡眠健康。 研究发现，围产期睡眠不佳与几种情况有关 已知会增加孕产妇健康并发症和死亡率的风险，如妊娠期 糖尿病、妊娠高血压、先兆子痫和抑郁症。此外，更大的风险 睡眠不佳报告的发生率发生在种族/少数民族中。然而，睡眠健康 孕妇和医疗保健提供者通常认为这些变化是“正常的”， 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成本效益，易于使用和可靠的睡眠 可以在家中使用的监控设备。目前的建议将研究以下方面的可行性： 使用可穿戴设备获取2导联EEG和ECG来监测怀孕期间的睡眠， 特别是在具有不良孕产妇结局高风险的美洲印第安人群体中。我们的假设 是：1）我们将有一个积极的经验，在家庭交付和收集设备的一般 所有种族和伦理群体的研究人群，2）我们将收集至少75%的可用数据， 隔夜记录，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 和更具侵入性的家庭监护仪解决方案。鉴于目前的情况，这项调查特别重要。 这一流行病影响了孕妇安排去医院就诊的能力和积极性， 基于医院的研究，使远程保健解决方案成为一种更可取的解决方案。 总之，睡眠已被证明是一个可改变的风险因素和实用工具的可用性 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， 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，促进美国的健康公平。

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.