Family dynamics, maternal stress, and the biomarkers of healthy pregnancy

项目摘要 全球经济和人类发展进展不平等的格局， 出生在发展中国家，这些变化伴随着城市化、移民和核化， 家庭中的性别差异也在改变儿童出生的家庭环境。出生时的健康差距是 不仅是因为经济不平等：母亲在家庭中的社会支持和社会地位 体现在怀孕的健康上，对终身健康产生影响。然而--尽管如此 这些不平等对公共卫生的重要性-因为以前的人口科学缺乏 了解这些过程所需的人群水平生物标志物-全面了解 发展中国家的家庭结构、怀孕压力和出生时健康状况的差异， 以前是可能的。在这个指导项目中，PI Diane Coffey将接受生物标志物的培训， 在发展中国家怀孕压力的生物过程。人群水平生物标志物培训 数据和压力生物学将使她的职业生涯成为一个独立的人口科学家，研究健康 怀孕是终身健康的开始。该项目有三个具体目标。根据目标1，科菲将获得 在关于孕妇的人口一级调查数据中使用生物标志物的指导培训（血液 压力，肥胖，葡萄糖和血红蛋白），在生物标志物（皮质醇，CRP）和生物学的压力， 怀孕和生物统计学。她将完成广泛的课程和指导阅读， 并参加生物标志物的研讨会和会议，以分析怀孕人口的数据。Aim 2为 PI进行人口内研究，研究家庭结构对压力生物标志物的影响， 妊娠和分娩结果。目标2的一部分将研究三代同堂家庭的重要性; 另一部分将调查伙伴缺席的后果。目标3：建设国际化 通过比较具有不同形式和强度的国家的结果， 性别歧视。实现这三个目标将使PI准备申请未来的R 01支持， 独立的人口科学家由此产生的研究议程将增加新的生物社会根源， 早期生命健康差异模型和全球疾病负担评估。

PROJECT SUMMARY Global patterns of unequal progress in economic and human development introduce disparities in health at birth. In the developing world, these changes, accompanied by urbanization, migration, and the nuclearization of households, are also changing the family context into which children are born. Gaps in health at birth are not only because of economic inequality: the social support and social status of mothers in their family contexts are embodied in the health of pregnancies, with consequences for lifelong wellness. However – and despite the importance of these inequalities for public health – because prior population science has lacked the population-level biomarkers needed to understand these processes – a comprehensive understanding of family structure, stress in pregnancy, and disparities in health at birth in the developing world has not previously been possible. In this mentored project, PI Diane Coffey will pursue training in the biomarkers and biological processes of stress in pregnancy in the developing world. Training in population-level biomarker data and stress biology will empower her career as an independent population scientist studying healthy pregnancy as a start to lifelong wellness. The project has three specific aims. Under Aim 1, Coffey will receive mentored training in the use of biomarkers in population-level survey data on pregnant women (blood pressure, obesity, glucose, and hemoglobin), in the biomarkers (cortisol, CRP) and biology of stress in pregnancy, and in biostatistics. She will complete an extensive program of coursework and guided reading, and attend workshops and conferences on biomarkers to analyze data for pregnant populations. Aim 2 is for the PI to conduct within-population studies of consequences of household structures for biomarkers of stress in pregnancy and birth outcomes. One part of Aim 2 will study the importance of three-generation households; another part will investigate the consequences of partner absence. Aim 3 is construct international comparisons and inform theory by comparing outcomes in countries with different forms and intensities of gender discrimination. Achieving these three aims will prepare the PI to apply for future R01 support as an independent population scientist. The resulting research agenda will add new biosocial root causes to existing models of early life health disparities and assessments of the global burden of disease.