Maternal and Developmental Risks from Environmental and Social Stressors (MADRES)

项目总结/摘要-总体中心 消除孕产妇保健成果方面的差距是国家的优先事项，特别是考虑到许多不利因素， 健康后遗症。此外，妊娠期可能是一个未被充分认识的易受环境影响的时期。 暴露和对以后孕产妇健康结果的影响。由于缺乏关于以下方面之间关系的数据， 产前暴露和压力与产后产妇健康，我们将重点更新周期， 来自环境和社会压力的孕产妇和发育风险（MADRES）中心对两名孕产妇 最令人关切的健康结果：产妇抑郁症和产后几年的心血管健康。 抑郁症是全世界与心理健康有关的发病率的主要原因，影响约3亿人 人与人之间的距离，几乎是两个人之间的距离。美国西班牙裔女性有独特的风险因素 包括克服与文化适应和利用不足相关的压力 精神健康护理服务。与此同时，心血管疾病（CVD）仍然是导致心血管疾病的头号原因。 死亡率和心血管疾病的患病率在美国妇女中继续攀升， 预防工作。产前出现的心血管疾病，如先兆子痫和 高血压，可能会持续影响到产后期，并预测晚年CVD的风险增加。 尽管有越来越多的证据，但很少有研究表明， 在这个脆弱时期的压力可能会促进心血管功能障碍或母亲抑郁年 后这一点在加州尤为重要，因为那里的暴露负担分布不均匀， 西班牙裔和非洲裔美国人承受着最大的环境暴露负担。 了解健康差异人群中孕产妇抑郁症和心血管疾病的危险因素 产后前4年是必要的，以减少不成比例的疾病负担， 个体MADRES中心将检查产前环境暴露和社会压力是否 导致产后抑郁和/或心血管风险因素增加， 与建筑环境的差异以及居住区和社区的物理、化学或社会压力因素， 邻域水平涉及包括非稳态负荷个体水平特征。MADRES中心 结合了三个创新的研究项目，一个强大的社区参与和传播核心， 全面的研究者发展核心和协同管理核心。MADRES中心 汇集了临床，环境，社会和公共卫生科学家和社区参与 专业人士创建一个世界级的研究计划，在环境健康的差距。我们的合作， 多学科方法将解决及时有效的疾病预防战略所需的关键差距 以及关于降低产后几年产妇发病率的方法的建议。

PROJECT SUMMARY/ABSTRACT—OVERALL CENTER Eliminating disparities in maternal health outcomes is a national priority, especially given the numerous adverse health sequelae. Moreover, pregnancy may be an underappreciated period of susceptibility to environmental exposures and impacts on later maternal health outcomes. Given the lack of data on the relationships between prenatal exposures and stressors with postpartum maternal health, we will focus the renewal cycle for the Maternal And Developmental Risks from Environmental and Social Stressors (MADRES) Center on two maternal health outcomes of utmost concern: maternal depression and cardiovascular health in the years after childbirth. Depression is the leading cause of mental health-related morbidity worldwide, affecting approximately 300 million people and is nearly twice as prevalent among women than men. US Hispanic women, have unique risk factors relative to non-Hispanic women including overcoming stress associated with acculturation and under-utilization of mental health care services. In parallel, cardiovascular disease (CVD) remains the number one cause of mortality and the prevalence of CVD has continued to climb among US women despite greater awareness and prevention efforts. Cardiovascular conditions that arise during the prenatal period, such as preeclampsia and hypertension, may have persistent effects into the postpartum period and predict elevated risk of later life CVD. Despite this growing evidence, there is little to no research on whether exposure to environmental and social stressors during this vulnerable period may promote cardiovascular dysfunction or maternal depression years later. This is particularly important in California, where the burden of exposures is not evenly distributed, with Hispanic and African-American populations carrying the greatest burden of environmental exposures. Understanding risk factors for maternal depression and CVD among health disparity populations in the first 4 years postpartum is necessary to reduce the disproportionate burden of disease borne by these individuals. The MADRES Center will examine whether prenatal environmental exposures and social stressors lead to higher depression and/or cardiovascular risk factors postpartum and whether patterns in exposure disparities from the built environment and physical, chemical or social stressors at the residential and neighborhood level relate to individual-level characteristics including allostatic load. The MADRES Center combines three innovative research projects, a strong Community Engagement and Dissemination Core, a comprehensive Investigator Development Core, and a synergizing Administrative Core. The MADRES Center brings together clinical, environmental, social and public health scientists and community engagement professionals to create a world-class research program in environmental health disparities. Our collaborative, multi-disciplinary approach will address key gaps needed for timely and effective disease prevention strategies and recommendations for approaches to reduce maternal morbidity in the years following childbirth.