Hypertensive Disorders of Pregnancy and Early Risk of Maternal CVD: Influence of the External Exposome

妊娠期高血压疾病和孕产妇心血管疾病的早期风险：外部暴露的影响

• 批准号: 10523580
• 负责人: Hui Hu
• 金额: $ 13.41万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10523580
• 关键词: Hypertensive; Disorders; Pregnancy; Early; Risk

PROJECT SUMMARY Hypertensive disorders of pregnancy (HDP) are the most common pregnancy complication and are associated with an increased long-term risk of cardiovascular disease (CVD) which is also the leading cause of death for women in the US. Emerging evidence suggests that environmental exposure during pregnancy may play an important role in the development of HDP. However, several limitations exist, including 1) the ignorance of residential mobility during pregnancy in exposure assessments, 2) the lack of studies considering different subtype, onset, and severity of HDP, and 3) the lack of considerations of the totality of environment (i.e. the exposome). While HDP have been linked to long-term CVD risk after pregnancy, limited data are available on early maternal CVD risk (within the first five years after delivery) complicated by HDP. More importantly, no study has focused on the impact of environmental exposures during and after pregnancy on maternal CVD risk after pregnancy. In addition, risk assessment models of HDP predominantly rely on biomarkers that are not ubiquitously tested among all pregnant women, and no predictive model has been developed to identify women at higher CVD risk after pregnancy. This study builds on our prior work in the external exposome and leverages our access to the unique statewide linked electronic health records-birth records data from the OneFlorida Clinical Research Consortium to address multiple challenges in the field by: 1) determining the association between pregnancy external exposome and risk of HDP, considering the subtype, onset, and severity of HDP and accounting for pregnancy residential mobility in exposure measurements; 2) assessing early risk of maternal CVD after pregnancy associated with HDP and the external exposome, and 3) developing predictive models of HDP and early risk of maternal CVD after pregnancy. This research project will be embedded in a comprehensive training program consisting of coursework, guided experiential and clinical learning, seminars, and mentorship by an established team of experts. The training program is designed to further my strengths and to develop new research skills while contributing to our scientific understanding of environmental impacts on cardiovascular health among pregnant and postpartum women. The training proposal details a five-year plan of formal and informal instruction in cardiovascular health, omics and exposome research, biomedical informatics and data science, and professional skills. My short-term career goals include completing coursework in all training areas, disseminating study findings through publications and presentations, engaging in career development activities, and applying for independent R01 funding in the third year of the award. My long-term career goal is to become an independent, collaborative, and productive epidemiologist and health data scientist leading research programs in cardiovascular health, with a focus on its intersection with perinatal and environmental epidemiology using big data.

项目摘要 妊娠期高血压疾病（HDP）是最常见的妊娠并发症， 心血管疾病（CVD）的长期风险增加，这也是死亡的主要原因， 美国的女人。新出现的证据表明，怀孕期间的环境暴露可能会影响怀孕期间的健康。 在HDP发展中发挥重要作用。然而，存在一些局限性，包括1）忽视 在接触评估中，怀孕期间的居住流动性，2）缺乏考虑不同 HDP的亚型，发病和严重程度，以及3）缺乏对环境整体的考虑（即， 麻烦）。虽然HDP与妊娠后的长期CVD风险有关，但关于以下方面的数据有限： 早期母体CVD风险（分娩后前五年内）并发HDP。更重要的是， 一项研究集中在怀孕期间和怀孕后环境暴露对母亲心血管疾病风险的影响 怀孕后。此外，HDP的风险评估模型主要依赖于生物标志物，这些生物标志物不是 在所有孕妇中普遍进行测试，并且没有开发出预测模型来识别 怀孕后CVD风险更高。这项研究建立在我们以前的工作，在外部麻烦， 利用我们对唯一的全州链接的电子健康记录-出生记录数据的访问， OneFlorida临床研究联盟通过以下方式解决该领域的多重挑战：1）确定 考虑到HDP的亚型、发病和预后， HDP的严重程度和在暴露测量中对妊娠居住流动性的解释; 2）评估 妊娠后母体CVD的早期风险与HDP和外部疾病相关，以及3） 开发HDP和妊娠后母体CVD早期风险的预测模型。该研究项目将 嵌入到一个全面的培训计划，包括课程，指导经验和临床 学习，研讨会，并由一个既定的专家团队指导。培训计划旨在 进一步发挥我的优势，发展新的研究技能，同时有助于我们对 环境对孕妇和产后妇女心血管健康的影响。培训 该提案详细介绍了一项关于心血管健康、组学和 麻烦的研究，生物医学信息学和数据科学，以及专业技能。我的短期职业生涯 目标包括完成所有培训领域的课程，通过出版物传播研究结果， 和演示文稿，从事职业发展活动，并申请独立的R 01资金， 获奖的第三年。我的长期职业目标是成为一个独立，协作和生产力 流行病学家和健康数据科学家领导心血管健康研究计划，重点是其 利用大数据与围产期和环境流行病学交叉。