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

项目摘要/摘要-整体中心 消除孕产妇健康结果方面的差异是国家的优先事项，特别是考虑到许多不利因素 健康后遗症。此外，怀孕可能是对环境敏感的一个被低估的时期。 暴露和对后来的孕产妇健康结果的影响。鉴于缺乏关于两国之间关系的数据 产前暴露和应激源与产后产妇健康，我们将重点更新周期为 来自环境和社会应激源的孕产妇和发育风险(MADRES)中心针对两名孕产妇 最令人关注的健康结果：产妇抑郁和产后数年的心血管健康。 抑郁症是全球心理健康相关疾病的主要原因，影响了大约3亿人。 而且在女性中的流行程度几乎是男性的两倍。美国拉美裔女性，有独特的风险因素 相对于非西班牙裔妇女，包括克服与文化适应和利用不足有关的压力 精神卫生保健服务的一部分。与此同时，心血管疾病(CVD)仍然是 美国女性的死亡率和心血管疾病患病率继续攀升，尽管人们对此有了更多的认识和 预防工作。产前出现的心血管疾病，如先兆子痫和 高血压，可能会对产后期产生持续影响，并预示着晚年心血管疾病风险的增加。 尽管证据越来越多，但很少或根本没有研究表明，暴露在环境和社会环境中 在这个脆弱的时期，压力因素可能会促进心血管功能障碍或产妇抑郁年 后来。这在加州尤为重要，在那里，暴露的负担并不均匀分布， 西班牙裔和非洲裔美国人的环境暴露负担最大。 了解中国健康差距人群中母亲抑郁和心血管疾病的危险因素 产后头4年是必要的，以减少不成比例的疾病负担 个人。马德雷斯中心将检查产前环境暴露和社会应激源 导致产后抑郁和/或心血管危险因素增加以及是否暴露于 与建成环境的差异以及住宅和住宅的物理、化学或社会应激源 邻区水平与包括均衡负荷在内的个体水平特征有关。马德雷斯中心 结合三个创新研究项目，一个强大的社区参与和传播核心，一个 综合调查员开发核心，以及协同管理核心。马德雷斯中心 汇聚临床、环境、社会和公共卫生科学家以及社区参与 专业人士创建世界级的环境健康差距研究计划。我们的协作、 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 并就减少分娩后几年产妇发病率的方法提出建议。

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.