Pregnancy complications in relation to stroke risk in African American women

与非裔美国女性中风风险相关的妊娠并发症

• 批准号: 10192830
• 负责人: Shanshan Sheehy
• 金额: $ 37.13万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-15 至 2023-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10192830
• 关键词: 21 year old; Address; Adult; Affect; African American; Age; American Heart Association; Awareness; Birth; Body mass index; Breast Feeding; Cardiovascular Diseases; Caucasians; Cause of Death; Characteristics; Childhood; Data; Databases; Diabetes Mellitus; Discrimination; Enrollment; European; Functional disorder; Funding; Gestational Diabetes; High Prevalence; High-Risk Pregnancy; Hypertension; Incidence; Individual; Knowledge; Life; Longevity; Longitudinal Studies; Mediating; Mediator of activation protein; Medical Records; Medicare; Mental Depression; Modification; National Cancer Institute; Non-Insulin-Dependent Diabetes Mellitus; Participant; Patient Self-Report; Patients; Physical activity; Physiological; Play; Policy Maker; Population; Postpartum Period; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Histories; Premature Birth; Psychosocial Factor; Race; Reporting; Research; Research Personnel; Research Project Grants; Resources; Respondent; Risk; Risk Assessment; Risk Factors; Role; Sexual abuse; Socioeconomic Status; Stroke; Stroke prevention; Third Pregnancy Trimester; Time; United States; Validation; Vulnerable Populations; Woman; Women' s Health; black women; childhood adversity; experience; follow-up; good diet; healthy lifestyle; high risk; insight; low socioeconomic status; men; non-smoking; public health relevance; racism; stroke incidence; stroke risk

PROJECT SUMMARY/ABSTRACT In the United States, African Americans (AAs) have a stroke risk twice that of Caucasians. The third-leading cause of death for women, stroke affects women more than men. Physiological changes due to pregnancy increase risk of stroke during the third trimester of pregnancy and postpartum. There is some evidence, primarily from Northern European populations, that the elevated risk may persist for years after delivery. The American Heart Association (AHA) recognizes pregnancy complications as risk factors for stroke in women, but called for more research among AA women on this topic—especially as AA women have a higher burden of pregnancy complications and there have been almost no studies on pregnancy complications and stroke in AA women. We propose to address this information gap in a population with a high prevalence of pregnancy complications, high burden of multiple life adversities, and a high risk of stroke, in the first large longitudinal study of AA women for this purpose. The Black Women's Health Study, begun in 1995, follows 59,000 AA women from across the U.S. and collects data every 2 years. Respondents have reported 1,845 incident strokes and 96,466 pregnancies since the study commenced. We propose to develop a resource for research on stroke in AA women by validating the self-reported stroke cases in the BWHS through medical records and Medicare linkage. We propose to assess whether pregnancy complications (preterm delivery, preeclampsia, gestational diabetes), individually and jointly, are associated with a higher risk of incident stroke in AA women in later years. We will also evaluate possible modification of the associations by factors such as healthy lifestyle (e.g., maintaining healthy post-pregnancy body mass index, healthy diet, non-smoking, physical activity) or by experiences of adversity (physical/sexual abuse, low socioeconomic status, experiences of racism and discrimination). We will investigate hypertension, type 2 diabetes, and depression as potential mediators that underlie the progression from pregnancy complications to stroke. The proposed study will be the first to address a critical unknown—whether and how pregnancy complications contribute to stroke incidence in AA women, a vulnerable population at high risk for pregnancy complications and stroke. The study will advance our understanding of potential mitigating factors postpartum that could lower risk of stroke for AA women. Knowledge gained from this proposal could inform patients, clinicians, researchers, and policy makers, and increase awareness' of pregnancy complications as stroke risk factors for AA women.

项目摘要/摘要 在美国，非裔美国人（AAS）的中风风险是高加索人的两倍。第三领先 女性死亡原因，中风对女性的影响比男性更大。怀孕引起的生理变化 在怀孕和产后三个月增加中风的风险。有一些证据， 来自北欧人口的主要人口，升高的风险可能会在分娩后数年持续数年。这 美国心脏协会（AHA）认为妊娠并发症是女性中风的危险因素， 但呼吁在AA女性中就该主题进行更多研究，尤其是AA女性负担更高 怀孕并发症，几乎没有关于怀孕并发症和中风的研究 妇女。我们建议在妊娠较高的人群中解决此信息差距 并发症，多种生命逆境的高燃烧以及中风的高风险，在第一个大纵向中 为此目的研究AA妇女。黑人妇女健康研究始于1995年，遵循59,000 aa 来自美国各地的妇女每两年收集一次数据。受访者报告了1,845起事件 自研究开始以来，中风和96,466例妊娠。我们建议开发一种研究资源 通过医疗记录验证BWH中的自我报告的中风病例和 Medicare链接。我们建议评估怀孕并发症（早产，先兆子痫， 单独和共同的妊娠糖尿病）与AA妇女的事件中风风险更高有关 在后来的几年。我们还将通过健康的因素来评估关联的可能修改 生活方式（例如，保持健康的怀孕后体重指数，健康饮食，无烟，身体 活动）或通过广告的经验（身体/性虐待，低社会经济地位，经验 种族主义和歧视）。我们将研究高血压，2型糖尿病和抑郁症 从怀孕并发症到中风的进展的基础的介体。拟议的研究将是 第一个解决关键未知的问题 - 以及怀孕并发症如何导致中风 AA妇女的发病率，脆弱的人口妊娠并发症和中风风险很高。研究 将促进我们对可能降低AA中风风险的潜在缓解因素的理解 女性。从该建议中获得的知识可以告知患者，临床医生，研究人员和政策制定者， 并提高对AA妇女中风风险因素的怀孕并发症的认识。