Project 1: DWHD, Lifetime Adversity and Reproductive-Aged Women

这项提案所审查的教区在五年内经历了“五场灾难”--卡特里娜飓风、丽塔飓风、古斯塔夫飓风、艾克飓风和DWH灾难。育龄妇女的身心健康不仅本身重要，而且对后代的健康也很重要。以往对环境灾害的研究大多表明，尽管环境灾害的物理影响通常是人们关注的主要来源，但这些灾害的心理影响可能更为重要。妇女易受灾后精神病理学的影响，孕妇和母亲可能特别脆弱。在怀孕期间经历压力以及患有抑郁症或其他心理健康问题的女性也会增加不良妊娠结局的风险，如低出生体重（LBW）和早产（PTB）。此外，一些环境污染物，如铅和空气污染，与不良妊娠结局有关。虽然有人提出，社会和环境逆境的影响可能是累积性的，并使健康差距永久化，但这一点很少 研究了我们建议比较不同程度暴露于DWH灾难的妇女的心理和身体健康结果。来自两个受影响社区的250名孕妇和非孕妇将在两年内被招募，并将被问及他们对石油泄漏的经历。卡特里娜飓风和其他灾难。他们还将提供血液样本，以确定铅和汞的水平。空气污染数据将从监测数据中收集。抑郁和焦虑水平，以及生育选择，将在这些妇女进行检查。在接下来的四年里，我们将再招募1000名孕妇，以研究灾害和环境暴露对分娩结果的影响。我们的具体目标是：1）确定DWH灾难对育龄妇女心理健康的影响; 2）确定DWH灾难对生殖结果（生殖选择，生育率，LBW，PTB）的影响; 3）确定一生的社会逆境对生殖结果的影响; 4）确定社会和环境逆境如何相互作用影响生殖结果。拟议的研究将是创新性的，将灾害心理学与压力和怀孕的研究结合在一起，研究终身社会逆境对生殖结果的作用，并研究社会逆境和环境污染之间的相互作用。

The parishes examined by this proposal have seen "five disasters in five years" - Hurricanes Katrina, Rita, Gustav, Ike, and the DWH disaster. The mental and physical health of women of reproductive age is important not only in itself, but for the health of future generations. Previous studies of environmental disasters largely indicate that although the physical effects of environmental disasters are usually the major source of concern, psychological effects of these disasters can be more significant. Women are vulnerable to post-disaster psychopathology, and pregnant women and mothers may be particularly vulnerable. Women who experience stress during their pregnancy and who have depression or other mental health problems are also at increased risk for adverse pregnancy outcomes like low birthweight (LBW) and preterm birth (PTB). In addition, some environmental contaminants, such as lead and air pollution, have been associated with adverse pregnancy outcomes. While it has been proposed that the effects of social and environmental adversity are likely to be cumulative and perpetuate health disparities, this has been little studied. We propose to compare mental and physical health outcomes in women exposed in varying degrees to the DWH disaster. 250 pregnant and non-pregnant women each, from two affected communities, will be recruited over two years, and will be questioned about their experience of the oil spill. Hurricane Katrina, and other adversities. They will also provide blood samples to determine lead and mercury levels. Air pollution data will be collected from monitoring data. Depression and anxiety levels, as well as reproductive choices, will be examined in these women. An additional 1000 pregnant women will be recruited over four years to allow us to examine the effects of the disasters and environmental exposures on birth outcomes. Our specific aims are 1) To determine the effect of the DWH disaster on the mental health of women of reproductive age; 2) To determine the effect of the DWH disaster on reproductive outcomes (reproductive choices, fertility, LBW, PTB); 3) To determine the effect of lifetime social adversity on reproductive outcomes, and 4) To determine how social and environmental adversity interact to affect reproductive outcomes. The proposed research will be innovative in bringing together the research on disaster psychology with stress and pregnancy, examining the role of lifetime social adversities on reproductive outcomes, and examining the interaction between social adversity and environmental contamination.