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

项目概要（摘要） 本K 01的研究目标是了解野火烟雾（WFS）暴露和其他孕产妇 压力因素在社会人口群体中汇聚并导致早产。早产 是新生儿死亡和残疾的主要决定因素。在美国有很大的差异， 美国印第安人/阿拉斯加原住民妇女的早产率比美国所有妇女的早产率高出26%。 妈妈们该研究将包括三个具体目标。(Aim 1）：评估暴露与 怀孕妇女的WFS和早产。我们假设母亲WFS暴露是 与不良出生结果相关，特别是在关键发育窗口期暴露时 怀孕我们将使用NOAA HYSPLIT模型开发一个历史的、空间上明确的WFS层。我们将 将联合收割机模型输出与2000-2020年的阿拉斯加出生记录（n= 220，000）相结合，以估计 WFS暴露和出生结果，控制母亲吸烟，年龄，产次和孕前共 病态(Aim 2）：评估WFS暴露与不良出生之间关系的影响修正 结果由产妇的特点，获得医疗保健，和地理偏远。我们将利用 从出生记录中提取信息进行分层分析。我们假设母亲的社会人口统计学 这些特征改变了WFS暴露与出生结果之间的关系。(Aim 3）：测试组合效果 怀孕期间的压力生活事件和早产时的WFS暴露。使用我们样本的子集 在怀孕风险评估监测系统（PRAMS）中，我们将通过以下方式纳入压力测量 领域（例如财务，关系）和压力生活事件的数量作为WFS的交互变量 exposure.这位候选人是密歇根大学环境健康系的终身助理教授。 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。她短暂的职业生涯 目标是扩大她对野火流行病学的研究，并制定一项研究计划，以了解 阿拉斯加的健康差异如何导致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。这个职业奖 将支持她在健康差距和混合方法研究，定性分析，先进的培训， 统计方法，以及将健康公平纳入适应规划。她的部门/导师团队 在环境流行病学，生物统计学，空气质量建模和转化研究的专业知识，她 校园提供了许多机会，以支持初级教师。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，以改善少数民族的健康和减少健康差距，加强严格的 采用定量和定性方法，以便能够对小群体进行分析， 在健康差异研究中纳入和使用地理标识符，以促进基于地点的研究。

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.