Ambient Air Pollution, Weather, and Placental Abruption (APWA)

环境空气污染、天气和胎盘早剥 (APWA)

• 批准号: 10487587
• 负责人: Cande V. Ananth
• 金额: $ 64.27万
• 依托单位: RBHS-ROBERT WOOD JOHNSON MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-10 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10487587
• 关键词: Abruptio Placentae; Acute; Address; Affect; Air Pollutants; Air Pollution; Air Pressure; Ammonium; Area; Big Data; Biological; Birth; Blood flow; Caliber; Calibration; California; Carbon; Censuses; Chronic; Conceptions; Crossover Design; Data; Data Science; Databases; Discipline of obstetrics; Etiology; Event; Exposure to; Fetal Growth; Fetal Growth Retardation; Fetal Heart Rate; First Pregnancy Trimester; Florida; Functional disorder; Future; Gestational Diabetes; Goals; Health; Heat Waves; Hemorrhage; High temperature of physical object; Hospitals; Humidity; Individual; Inflammatory; Inhalation; Ischemia; Link; Live Birth; Location; Massachusetts; Measurement; Mediating; Mediation; Michigan; Mothers; National Institute of Environmental Health Sciences; Nature; Neighborhoods; Newborn Infant; Nitrates; Nitrogen Dioxide; Non-linear Models; Outcome; Ozone; Particulate Matter; Partner in relationship; Pathway interactions; Physiological; Placenta; Placenta Diseases; Pre-Eclampsia; Pregnancy; Pregnant Women; Premature Birth; Premature Rupture Fetal Membranes; Process; Public Health; Research; Residential Mobility; Resolution; Risk; Risk Factors; Role; Severities; Socioeconomic Status; South Carolina; Sulfate; Temperature; Time; United States National Institutes of Health; Ursidae Family; Uterine Contraction; Weather; Woman; ambient air pollution; base; cohort; cold temperature; design; early pregnancy; extreme heat; fetus hypoxia; fine particles; implantation; infant death; obstetrical complication; perinatal outcomes; policy implication; pollutant; population based; predictive modeling; premature; prepregnancy; residence; spatiotemporal; stem; stillbirth; thrombotic

ABSTRACT Placental abruption results in hemorrhage, ischemia, and fetal hypoxia, placing a tremendous health burden on both the mother and the newborn. Efforts to understand the etiology of this devastating obstetrical complication have been disap- pointing. This project will delineate environmentally-associated pathways to abruption and determine the impact of pol- lutant triggers that are implicated in acute versus chronic placental abruption. Given that one-fourth of all abruption cases have an acute etiology and 15% of abruptions may recur in future pregnancies, the role of environmental triggers is a critically important, yet unexplored, opportunity to understand the pathophysiology of this enigmatic obstetrical compli- cation. The project will capitalize on high resolution exposure and health outcome data as it aims to develop a birth linkage database that will include hospital discharges linked to both stillbirths and live births-infant deaths to resident women in California, Florida, Massachusetts, Michigan, and South Carolina (estimated 16 million births, including 155,000 abruption cases) between 2000–2016. For each pregnancy we will assign average daily ambient exposure to fine particulate matter with an aerodynamic diameter ≤2.5 µm (PM2.5), its constituents (elemental carbon and organic carbon, sulfate, nitrate, and ammonium), as well as gaseous pollutants (nitrogen dioxide and ozone), using spatiotemporally resolved models that predict exposure for each residential location. We will also assign every residence with average daily temperature, humid- ity, dew point, heat waves, and atmospheric air pressure. The project will focus on disentangling the relative contributions of ambient air pollution and weather-related conditions on acute abruption through a bi-directional, time-stratified case- crossover design, and those of abruptions with chronic underpinnings using a cohort design. We will apply distributed lag linear and non-linear models to identify critical windows of exposure, Bayesian Kernel Machine Regression to characterize associations based on multi-pollutant exposures, and causal interaction-mediation decomposition analyses through ischemic placental disease (preeclampsia, fetal growth disturbances). We will consider individual– and neighborhood–level con- founders derived from residential census tracts. All associations will be corrected for simultaneous exposure and outcome misclassification, as well as for exposure measurement error owing to maternal residential mobility through a regression calibration approach. The ubiquitous nature of air pollution and weather exposures and their potential impact on adverse perinatal outcomes, as well as the preliminary data supporting the associations, presents unprecedented opportunities to address implications of the adverse impact of air pollution and weather-related exposures on placental abruption and related obstetrical complications. This project aligns with 2 major critical areas of research–Co-exposures, and Data Sci- ence and Big Data–outlined in the 2018-2023 strategic goals of NIH-National Institute of Environmental Health Sciences.

抽象的 胎盘早剥会导致出血、缺血和胎儿缺氧，给胎儿和胎儿带来巨大的健康负担。 母亲和新生儿。了解这种毁灭性产科并发症的病因的努力已经失败。 指点。该项目将描绘与环境相关的中断途径并确定污染的影响 与急性与慢性胎盘早剥有关的突变触发因素。鉴于所有胎盘早剥病例中有四分之一 具有急性病因，并且 15% 的胎盘早剥可能会在未来怀孕中再次发生，环境触发因素的作用是 这是了解这一神秘产科并发症的病理生理学的至关重要但尚未探索的机会 阳离子。该项目将利用高分辨率暴露和健康结果数据，旨在建立出生联系 数据库将包括与死产和活产相关的出院情况——居民妇女的婴儿死亡 加利福尼亚州、佛罗里达州、马萨诸塞州、密歇根州和南卡罗来纳州（估计有 1600 万新生儿，其中 155,000 例早产） 例）2000-2016 年。对于每次怀孕，我们都会分配平均每日环境接触细颗粒物的情况 空气动力学直径≤2.5 µm (PM2.5)，其成分（元素碳和有机碳、硫酸盐、硝酸盐、 和铵），以及气态污染物（二氧化氮和臭氧），使用时空解析模型 预测每个居住地点的暴露程度。我们还将为每个住宅分配日平均温度、湿度- 度、露点、热浪和大气压力。该项目将侧重于理清相关贡献 通过双向、时间分层的案例来研究环境空气污染和天气相关条件对急性骤变的影响 交叉设计，以及使用队列设计的具有慢性基础的中断。我们将应用分布式滞后 线性和非线性模型来识别关键暴露窗口，贝叶斯核机器回归来表征 基于多污染物暴露的关联，以及通过缺血进行因果相互作用介导分解分析 胎盘疾病（先兆子痫、胎儿生长障碍）。我们将考虑个人和社区层面的反对 创始人来自住宅人口普查区。所有关联都将针对同时暴露和结果进行纠正 错误分类，以及由于母亲居住流动性导致的暴露测量误差 校准方法。空气污染和天气暴露的普遍性及其对不利影响的潜在影响 围产期结局以及支持这些协会的初步数据提供了前所未有的机会 解决空气污染和与天气相关的暴露对胎盘早剥的不利影响的影响 相关的产科并发症。该项目符合两个主要的关键研究领域——共同暴露和数据科学—— 环境健康和大数据——NIH-国家环境健康科学研究所 2018-2023 年战略目标中概述。