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.

项目总结/摘要 在美国，非裔美国人（AAs）的中风风险是白人的两倍。第三大 中风是女性的主要死因，对女性的影响大于男性。妊娠引起的生理变化 增加妊娠晚期和产后中风的风险。有一些证据， 主要来自北方欧洲人群，分娩后高风险可能持续数年。的 美国心脏协会（AHA）认为妊娠并发症是女性中风的危险因素， 但呼吁对AA女性进行更多关于这一主题的研究-特别是AA女性有更高的负担 妊娠并发症和几乎没有关于妊娠并发症和中风的研究， 戒酒会的女人。我们建议在怀孕率高的人群中解决这一信息差距 在第一个大型纵向调查中，并发症、多种生活逆境的高负担以及中风的高风险 为此目的对AA妇女进行研究。1995年开始的黑人妇女健康研究跟踪了59,000名AA 来自美国各地的女性，每两年收集一次数据。受访者报告了1，845起事件 中风和96,466例妊娠。我们建议开发一个研究资源 通过医疗记录验证BWHS中自我报告的卒中病例， 医疗保险联系。我们建议评估妊娠并发症（早产，先兆子痫， 妊娠期糖尿病），单独和联合，与AA妇女发生卒中的风险较高相关 在以后的岁月里。我们还将评估可能的修改的协会的因素，如健康 生活方式（例如，保持健康的怀孕后体重指数，健康饮食，不吸烟，身体健康 活动）或逆境经历（身体/性虐待，社会经济地位低下， 种族主义和歧视）。我们将调查高血压、2型糖尿病和抑郁症作为潜在的 从妊娠并发症发展到中风的介质。拟议的研究将 第一个解决一个关键的未知问题--妊娠并发症是否以及如何导致中风 AA妇女的发病率，这是一个易受影响的人群，妊娠并发症和中风的风险很高。研究 将促进我们对产后可能降低AA卒中风险的潜在缓解因素的理解 妇女从这一建议中获得的知识可以为患者、临床医生、研究人员和政策制定者提供信息， 提高对妊娠并发症作为AA妇女中风危险因素的认识。