Convergence of multiple exposures during pregnancy: Effect of wildfires and maternal stressors on birth outcomes among Alaskan women

项目摘要(摘要) 本K01的研究目标是了解野火烟雾(WFS)暴露和其他母体 应激源汇聚在一起，在不同的社会人口群体中对早产有不同的贡献。早产 是新生儿死亡和残疾的主要决定因素。在美国有很大的差距，在那里 美国印第安人/阿拉斯加原住民妇女的早产率比美国所有土著妇女的早产率高出26%。 母亲们。这项研究将包括三个具体目标。(目标1)：评估接触之间的联系 从阿拉斯加的孕妇到WFS和早产。我们假设母体接触WFS是 与不良的出生结局有关，特别是当暴露在关键的发育窗口 怀孕了。我们将使用NOAA HYSPLIT模型开发一个历史的、空间上显式的WFS层。我们会 将模型输出与阿拉斯加2000-2020年(n=220,000)的出生记录结合起来，估计两者之间的关联 WFS暴露和出生结局，控制母亲吸烟、年龄、产次和孕前共同 病态。(目标2)：评估WFS暴露与不利出生之间关系的效果修正 由母亲特征、获得医疗保健的机会和地理位置决定的结果。我们将利用 来自出生记录的信息，以进行分层分析。我们假设产妇的社会人口 这些特征改变了接触WFS和出生结局之间的关系。(目标3)：检验综合效应 怀孕期间的应激性生活事件和早产时暴露于WFS。使用我们样例的子集 包括在怀孕风险评估监测系统(PRMS)中，我们将通过 压力性生活事件的领域(如财务、关系)和数量作为与WFS的交互变量 曝光。这位候选人是加州大学环境健康系终身教授。 阿拉斯加-安克雷奇，接受流行病学、生物统计学、生态学方法和地理信息系统方面的培训。她的短期职业生涯 目标是扩大她对野火流行病学的研究，并制定一个研究计划，以了解 阿拉斯加的健康差距如何促进气候变化对健康的影响。她的长期职业目标是 领导一个应用研究小组，进行严格的、社区响应的研究。这个职业生涯奖 将支持她在健康差异和混合方法研究、定性分析、高级 统计方法，并将卫生公平纳入适应规划。她的部门/导师团队 环境流行病学、生物统计学、空气质量建模和转化研究方面的专业知识，以及HER 校园提供了许多支持初级教员的机会。这些经验和资源将支持 这里提出的工作，以及未来关于环境正义问题的跨学科研究。这项建议 支持NIMHD的使命，通过加强严谨的 定量和定性方法，以实现对小人口的分析和开发方法学 在健康差异研究中纳入和使用地理标识，以促进以地点为基础的研究。

PROJECT SUMMARY (ABSTRACT) The research objective of this K01 is to understand how wildfire smoke (WFS) exposure and other maternal stressors converge and contribute to preterm birth differentially across socio-demographic groups. Prematurity is a major determinant of newborn death and disability. There are substantial disparities in the U.S. where the rate of preterm births among American Indian/Alaska Native women is 26% higher than the rate among all U.S. mothers. The research will consist of three Specific Aims. (Aim 1): Evaluate the association between exposure of pregnant women in Alaska to WFS and preterm birth. We hypothesize that maternal WFS exposure is associated with adverse birth outcomes, particularly when exposed at critical developmental windows during gestation. We will develop a historical, spatially explicit WFS layer using the NOAA HYSPLIT model. We will combine model output with Alaskan birth records from 2000-2020 (n=220,000) to estimate associations between WFS exposure and birth outcomes, controlling for maternal smoking, age, parity, and pre-pregnancy co- morbidities. (Aim 2): Assess effect modification of the relationship between WFS exposure and adverse birth outcomes by maternal characteristics, access to healthcare, and geographic remoteness. We will utilize information from birth records to conduct stratified analyses. We hypothesize that maternal socio-demographic characteristics modify the relation between WFS exposure and birth outcomes. (Aim 3): Test the combined effect of stressful life events during pregnancy and WFS exposure on preterm birth. Using a subset of our sample included in the Pregnancy Risk Assessment Monitoring System (PRAMS), we will include measures of stress by domain (e.g. financial, relationship) and number of stressful life events as interaction variables with WFS exposure. The candidate is a tenure-track Assistant Professor of Environmental Health at the University of Alaska-Anchorage with training in epidemiology, biostatistics, ecology methods, and GIS. Her short-term career goals are to expand her research on wildfire epidemiology, and to develop a research program to understand how health disparities in Alaska contribute to the health impacts of climate change. Her long-term career goal is to lead an applied research group that conducts rigorous, community-responsive research. This career award will support her training in health disparities and mixed methods research, qualitative analysis, advanced statistical methods, and integration of health equity into adaptation planning. Her department/mentor team have expertise in environmental epidemiology, biostatistics, air quality modeling, and translational research, and her campus offers many opportunities to support junior faculty. These experiences and resources will support the work proposed here, as well as future interdisciplinary research on environmental justice issues. This proposal supports the NIMHD mission to improve minority health and reduce health disparities by strengthening rigorous quantitative and qualitative methods to enable analysis on small populations and developing methodologies for incorporating and using geographic identifiers in health disparities research to promote place-based research.