Maternal exposure to childhood abuse and disparities in offspring neurodevelopment:Effects of COVID-19 pandemic-related stress

项目摘要 儿童期遭受虐待的妇女的子女表现出多种神经发育障碍的风险增加。 这些儿童患有焦虑症、抑郁症、自闭症和注意力缺陷障碍（ADHD）。的 父母补助金旨在确定怀孕期间可能导致这种风险增加的生物失调。 炎症和激素失调会损害后代的神经发育， 经历过童年虐待，但不知道这些系统的失调是否会在儿童时期继续存在。 遭受虐待的妇女怀孕期间，是对后代大脑产生影响的关键时期。父母补助金 在怀孕期间收集生物样本， 前瞻性的女性队列。有童年虐待史的妇女在怀孕期间会经历更多的压力。 怀孕，和目标2的父母补助金假定，这些压力可能部分占怀孕 生物失调在这份行政补充文件中，我们建议扩大研究范围， 及COVID-19疫情的时间敏感数据。我们假设与流行病相关的不良事件 和压力将更常见于妇女暴露于虐待儿童，并会增加风险的生物 怀孕期间的失调对后代的发育有害。妊娠期间不良事件 对它们的心理反应与怀孕并发症、早产、低出生率有关 体重和后代神经发育缺陷。包括妇女在内的易受伤害人口 儿童虐待，可能会经历更多的这些不良事件，并受到更多的负面影响， 他们预测模型表明，在没有疫苗的情况下，SARS-CoV-2很可能会持续下去。 在可预见的未来，强调迫切需要对长期健康进行强有力的研究， 大流行病对孕妇及其后代的影响。通过家长奖注册的参与者是 护士健康研究3的成员，大多数都是临床活跃的，因此这项研究的优点是 直接接触大量职业性接触SARS-CoV-2风险高的人群。在同一 同时，他们很容易受到医疗保健部门裁员和失业的影响，这使得这一群体成为研究 与大流行病有关的压力因素对怀孕和分娩结果的影响。该补编将收集以下数据： 孕前和孕期的COVID-19相关不良事件和COVID-19相关压力， 包括对感染的恐惧、经济压力、与流行病有关的抑郁症、养育压力和疾病， 亲人的死亡。这项研究将解决NICHD的核心使命，以确保"所有儿童都有 有机会实现他们的健康和富有成效的生活的充分潜力"，通过确定因素，"开始之前， 概念，[这]可以影响整个生命过程和几代人的发展。

PROJECT SUMMARY Children of women exposed to childhood abuse exhibit increased risk for a wide array of neurodevelopmental deficits and are at elevated risk of anxiety, depression, autism, and attention deficit disorder (ADHD). The parent grant seeks to identify biological dysregulation during pregnancy that may cause this increased risk. Inflammation and hormonal dysregulation harms offspring neurodevelopment and is present in adults who have experienced childhood abuse, yet it is unknown whether dysregulation in these systems continues during the pregnancies of women exposed to abuse, the critical time for effects on offspring brains. The parent grant collects biological samples during pregnancy to measure inflammation and hormonal dysregulation in a large, prospective cohort of women. Women with histories of childhood abuse experience more stressors during pregnancy, and Aim 2 of the parent grant posits that these stressors may partially account for pregnancy biological dysregulation. In this administrative supplement, we propose to augment the study to capture key and time sensitive data on the COVID-19 pandemic. We hypothesize that pandemic-related adverse events and stress will be more common in women exposed to child abuse and will increase risk for biological dysregulation during pregnancy that is harmful to offspring development. Adverse events during pregnancy and psychological reactions to them have been linked to pregnancy complications, prematurity, low birth weight, and offspring neurodevelopmental deficits. Vulnerable populations, including women exposed to childhood abuse, are likely to experience more of these adverse events and be more negatively impacted by them. Forecasting models suggest that in the absence of a vaccine, SARS-CoV-2 is likely to continue circulating for the foreseeable future, highlighting the urgent need for robust research on the long-term health effects of the pandemic on pregnant women and their offspring. Participants enrolled via the parent award are members of the Nurses' Health Study 3, and most are clinically active, thus this study has the advantage of having direct access to a large population with high risk of occupational exposure to SARS-CoV-2. At the same time, they are vulnerable to healthcare sector downsizing and job loss, making the cohort ideal for studying the effects of pandemic-related stressors on pregnancy and birth outcomes. The supplement will collect data on COVID-19-related adverse events and COVID-19-related stress at both pre-pregnancy and pregnancy, including fear of infection, financial stress, pandemic-related depression, parenting stress, and illness and death of loved ones. This research will address the NICHD's core mission to ensure that “all children have the chance to achieve their full potential for healthy and productive lives” by identifying factors, “starting before conception, [that] can influence development across the life course and across generations.”