Helping Us Grow Stronger (HUGS/Abrazos): COVID-19 in pregnancy and reducing toxic stress in mother-infant dyads

项目总结 怀孕和儿童早期标志着一个独特的时期，两个人的生活可能会受到 存在母亲压力因素，如经济不稳定、精神健康状况不佳和社会不平等，所有这些都 而新冠肺炎疫情更是放大了这种影响。COVID大流行也与 种族主义和孕产妇死亡率的流行困扰着美国，已经产生了不成比例的影响- 大波士顿地区边缘化的黑人和拉丁裔孕妇。在缺乏保护的情况下 缓冲，长期暴露在过度的逆境中(“有毒压力”)会导致双方的健康状况不佳。 母亲和婴儿。改善产妇心理健康和减轻社会决定因素的有效干预措施 因此，迫切需要对妊娠合并新冠肺炎患者的健康状况进行评估。 帮助我们变得更强大(Hugs/Abrazos)是一项基于社区的计划，在 冠状病毒大流行。Hugs/Abrazos结合了紧急救援、患者导航和直接行为健康 支持培养复原力和减轻与COVID相关的毒性应激对孕妇和 产后妇女及其家人。参与者在马萨诸塞州综合医院的新冠肺炎注册 如果怀孕生物库的SARS-CoV-2检测呈阳性，将被提交给Hugs/Abrazos计划。 使用有效的调查工具，我们将评估该计划在多大程度上改善了母亲的压力， 焦虑、抑郁、生活质量、食品不安全以及在这个高风险地区的种族主义和歧视经历 怀孕人口。我们还将评估母亲新冠肺炎相关炎症对 通过对参与者储存的血清样本进行细胞因子分析得出的行为健康结果。这很紧急 R01《母体肥胖中胎脑-胎盘免疫激活》的竞争性修订与 R01‘S的长期翻译目标：了解宫内暴露于母体炎症和 免疫激活影响胎儿的编程，以便创造有针对性的干预措施，以改善短期- 以及面对母亲暴露的长期孕产妇和儿童健康结果。这项工作将产生 关于以社区为基础的新型干预措施的有效性的关键知识，以减少 母亲感染SARS-CoV-2对母婴二联体的影响，并改善跨代结局。

PROJECT SUMMARY Pregnancy and early childhood mark a unique period when two lives can be permanently impacted by the presence of maternal stressors such as economic instability, poor mental health, and social inequities, all of which have been amplified by the COVID-19 pandemic. The COVID pandemic has also collided with the epidemics of racism and maternal mortality plaguing the United States, to disproportionately impact already- marginalized Black and Latinx pregnant individuals in the greater Boston area. In the absence of protective buffers, prolonged exposure to excessive adversity (“toxic stress”) can lead to poor health outcomes for both mothers and infants. Effective interventions to improve maternal mental health and mitigate social determinants of health in individuals with COVID-19 in pregnancy are therefore urgently needed. Helping Us Grow Stronger (HUGS/Abrazos) is a community-based program, designed and launched during the COVID pandemic. HUGS/Abrazos combines emergency relief, patient navigation, and direct behavioral health support to foster resilience and mitigate the negative impacts of COVID-related toxic stress on pregnant and postpartum women and their families. Participants enrolled in Massachusetts General Hospital’s COVID-19 Pregnancy Biorepository will be referred to the HUGS/Abrazos program if they test positive for SARS-CoV-2. Using validated survey instruments, we will assess the extent to which the program improves maternal stress, anxiety, depression, quality of life, food insecurity, and experiences of racism and discrimination in this high-risk pregnant population. We will also assess the impact of maternal COVID-19-associated inflammation on behavioral health outcomes using cytokine analysis of banked serum samples from the participants. This urgent competitive revision of the R01 “Fetal Brain-Placental Immune Activation in Maternal Obesity” is aligned with the R01’s long-term translational goals: to understand how in utero exposure to maternal inflammation and immune activation impacts fetal programming, in order to create targeted interventions that can improve short- and long-term maternal and child health outcomes in the face of maternal exposures. This work will generate key knowledge about the efficacy of a novel community-based intervention to reduce the adverse impact of maternal SARS-CoV-2 infection on the mother-infant dyad, and improve transgenerational outcomes.