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

项目 2：母亲怀孕后暴露于环境和心理社会压力以及心血管风险

• 批准号: 10376832
• 负责人: Shohreh F Farzan
• 金额: $ 26.44万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10376832
• 关键词: Acculturation; Air Pollutants; Air Pollution; Birth; Blood Pressure; Body mass index; California; Cardiovascular Diseases; Cardiovascular system; Caring; Chronic; Chronic Disease; Communities; Country; Data; Development; Elderly; Environment; Environmental Exposure; Environmental Risk Factor; Epigenetic Process; Exposure to; Fetus; Gene Targeting; Gestational Diabetes; Glucose Intolerance; Glycosylated Hemoglobin; Glycosylated hemoglobin A; Health; Hispanic; Homeostasis; Hypertension; Inflammation; Language; Light; Link; Lipids; Maternal Exposure; Maternal Health; Mediating; MicroRNAs; Minority Groups; Modification; Mothers; Pathway interactions; Physiological Adaptation; Population; Postpartum Period; Pre-Eclampsia; Predisposition; Pregnancy; Pregnancy Complications; Prevalence; Prevention; Psychosocial Stress; Research; Risk; Risk Factors; Role; Testing; Urban Community; Waist-Hip Ratio; Woman; Women' s Health; Work; ambient air pollution; blood lipid; cardiovascular disorder risk; cardiovascular effects; cardiovascular health; cardiovascular risk factor; cohort; disadvantaged women; environmental stressor; experience; follow-up; gestational weight gain; health disparity populations; postpartum care; preference; prenatal; prenatal environmental exposure; prenatal exposure; prepregnancy; prospective; psychosocial stressors; social; social stressor; sociodemographics; socioeconomic disadvantage; stressor; virtual

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.

项目概要/摘要-项目2 心血管疾病（CVD）的患病率在美国女性中继续攀升，尽管 加大预防力度。怀孕可能提供了一个未充分研究的窗口，以了解妇女的长期 心血管健康正常的生理适应，以支持胎儿可以作为一个压力源，对妇女的 身体，可能暴露或加剧潜在的慢性疾病。血管相关 并发症，如先兆子痫和高血压，可能会持续影响到产后期 并与晚年心血管疾病风险升高有关。此外，环境暴露，如空气污染 与母体血压和脂质稳态的改变有关，而心理社会压力因素 可能通过增加炎症和产前高血压风险独立影响孕产妇健康 紊乱努力了解产前环境和心理社会压力的作用 心血管并发症和长期孕产妇健康风险可能是健康差距中最关键的 生活在城市社区的人口，他们不成比例地受到多种因素的综合影响， 可能加剧健康风险的社会、身体和环境压力因素。尽管越来越多的证据表明 关于这类暴露对妊娠期母体心血管健康的影响，几乎没有研究 关于产前期间的环境暴露和社会压力是否会增强 母亲在产后期间和以后的生活中的心血管风险，特别是在少数群体中。甚至 关于产后背景下这些影响的机制知之甚少，但最近的研究表明， 支持miRNAs在妊娠和CVD风险中的关键作用，并表明这些表观遗传调节因子 可以通过环境暴露来调节。我们建议调查是否产前交通有关， 环境空气污染暴露增加了500名妇女的产后心血管影响， MADRES队列，一项主要为西班牙裔、社会经济弱势人群的前瞻性妊娠队列 妇女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， 妊娠期社会压力对产后4年心血管危险因素的影响 并检查这些影响是否因妊娠相关并发症和文化适应因素而异;（2） 确定心血管相关miRNA在产前空气污染相关协会中的作用， 产后前四年的心血管健康轨迹，并测试它们是否介导这些 协会，并检查其功能的相关性。这些结果可能有助于阐明 环境和社会压力对产后期心血管疾病危险因素的影响， 确定妇女在晚年患慢性病的风险更大。