Project 2: Maternal Exposure to Environmental and Psychosocial Stressors and Cardiovascular Risks after Pregnancy

项目摘要/摘要--项目2 心血管疾病(CVD)的患病率在美国女性中持续攀升，尽管 加大预防力度。怀孕可能为了解女性的长期生活提供了一个未被充分研究的窗口 心血管健康。支持胎儿的正常生理适应会对女性的 身体，有可能暴露或加重潜在的慢性病。与心血管相关的 并发症，如先兆子痫和高血压，可能会对产后持续产生影响。 并与晚年心血管疾病风险升高有关。此外，空气污染等环境暴露 与母亲血压和血脂动态平衡的改变有关，而心理社会应激源 可能通过增加炎症和产前高血压风险独立影响产妇健康 精神错乱。努力了解环境和心理社会压力在产前中的作用 在健康差距中，心血管并发症和长期产妇健康风险可能是最严重的 生活在城市社区的人口，他们不成比例地经历了多个 可能加剧健康风险的社会、身体和环境应激源。尽管越来越多的证据表明 孕期这种暴露对产妇心血管健康的影响，几乎没有研究 关于产前期间环境暴露和社会应激源是否会增强 母亲在产后期和晚年的心血管风险，特别是在少数群体中。连 人们对产后环境中这些影响的潜在机制知之甚少，但最近的研究 支持miRNAs在怀孕和心血管疾病风险中的关键作用，并建议这些表观遗传调控因子 会受到环境暴露的影响。我们建议调查是否与产前交通有关和 环境空气污染暴露增加了500名妇女产后心血管影响 Madres Cohort，一个预期怀孕的队列，主要是西班牙裔，在社会经济上处于不利地位 女人。我们将通过以下具体目标来实现这一目标：(1)调查空气污染物的影响和 孕期社会应激源对产后前四年心血管危险因素的影响 并研究这些影响是否因妊娠相关并发症和文化适应因素而有所不同；及(2) 确定心血管相关miRNA在产前空气污染相关关联中的作用 产后四年的心血管健康轨迹，并测试它们是否在这些轨迹中起中介作用 并检查它们的功能相关性。这些结果可能有助于揭示 环境和社会应激源对产后心血管疾病危险因素的影响 确定女性在晚年罹患慢性病的风险较大。

PROJECT SUMMARY/ABSTRACT—PROJECT 2 The prevalence of cardiovascular disease (CVD) has continued to climb among US women, despite greater prevention efforts. Pregnancy may provide an understudied window into a woman’s long-term cardiovascular health. Normal physiological adaptations to support a fetus can act as a stressor on a woman’s body, potentially uncovering or exacerbating underlying chronic conditions. Cardiovascular-related complications, such as preeclampsia and hypertension, may have persistent effects into the postpartum period and have been related to elevated CVD risk in later life. Moreover, environmental exposures such as air pollution have been associated with altered maternal blood pressure and lipid homeostasis, while psychosocial stressors may independently influence maternal health by increasing inflammation and risk of prenatal hypertensive disorders. Efforts to understand the roles of both the environment and psychosocial stress in prenatal cardiovascular complications and long-term maternal health risks may be most critical among health disparity populations living in urban communities, who disproportionately experience the combined impacts of multiple social, physical, and environmental stressors that may exacerbate health risks. Despite growing evidence of the impact of such exposures on maternal cardiovascular health during pregnancy, there is little to no research available on whether environmental exposures and social stressors during the prenatal period may enhance a mother’s cardiovascular risk in the postpartum period and into later life, particularly in minority populations. Even less is known about the mechanisms underlying these effects in the postpartum context, but recent studies support a key role for miRNAs in both pregnancy and in risk of CVD and suggest that these epigenetic regulators can be modulated by environmental exposures. We propose to investigate whether prenatal traffic-related and ambient air pollution exposures increase maternal postpartum cardiovascular effects in 500 women in the MADRES cohort, a prospective pregnancy cohort of predominantly Hispanic, socioeconomically-disadvantaged women. We will accomplish this by the following specific aims: (1) investigate the impact of air pollutants and social stressors during pregnancy on trajectories of cardiovascular risk factors in the first four years postpartum and examine whether these effects vary by pregnancy-related complications and acculturation factors; and (2) determine the role of cardiovascular-related miRNA in prenatal air pollution-related associations in cardiovascular health trajectories in the first four years postpartum, and test whether they mediate these associations and examine their functional relevance. These results may shed light on the contribution of environmental and social stressors to CVD risk factors in the postpartum period and could be critical for identifying women at greater risk of developing chronic disease in later life.