Maternal and Infant Environmental Health Riskscape (MIEHR) Research Center

摘要 气候变化是全球范围内前所未有的公共卫生危机，其威胁日益严重， 特别是对于居住在沿海地区的人。母亲和儿童的健康风险尤其令人关切 越来越多的证据表明，气温升高对孕产妇和儿童健康产生影响。而相对较少的 调查研究了温度对黑人、棕色人种和土著母亲的不同影响， 在围产期健康方面存在种族/族裔差异的证据是压倒性的，而且令人不安地长期存在。 此外，少数民族和低收入家庭由于接触化学品和非化学品而面临“双重危险”。 和非化学应激源在多种环境中。为了解决这些不平等问题， 环境健康风险景观（MIEHR）研究中心，NIMHD/NIEHS/NICHD P50中心 卓越的环境健康差异研究成立，以阐明的贡献， 环境风险景观的生物、物理、社会和建筑环境 黑人和白色孕妇及其婴儿的健康差异。MIEHR中心有两个 协同研究项目：项目1：环境风险、灾害和产科结果， 流行病学研究，以确定接触化学品混合物与 基于地点的压力源和早产以及项目2：母婴差异意识分类 健康，一项生物信息学研究，旨在开发和验证黑人早产的差异感知分类器， 白色女人。为了支持这两个项目，我们正在招募妇女谁目前的劳动和分娩在产科 德克萨斯州医疗中心（TMC）是世界上最大的医疗中心。TMC在更大的 休斯顿，在种族/民族概况以及经济方面拥有非常多样化的人口， 贫富的二元性。此外，该地区经历了极其炎热和潮湿的夏季， 靠近墨西哥湾沿岸，容易遭受飓风和洪水。通过利用MIEHR中心基础设施 并在我们之前的工作基础上，应用分布式滞后非线性模型（DLNLM）对暴露进行建模， 具有非线性和滞后效应，我们建议评估气温上升和出生之间的关联 体重，围产期的结果，增加了健康风险的婴儿在其整个生命过程。具体目标 1）扩大MIEHR环境风险范围，编制温度测量的时间序列 研究参与者在怀孕期间的其他气象变量; 2）应用DLNLM调查 暴露于温度和出生体重的关键窗口;和3）检查母亲的年龄，种族， 基于地点的压力改变了高温和出生体重之间的关联。结果将奠定 为将气候灾害作为当前MIEHR环境风险景观的关键要素奠定基础 中心的研究项目，并在一项新的分析，确定暴露于高温的敏感窗口 这将为将来保护孕妇免受热暴露的努力提供信息。

ABSTRACT Climate change represents an unprecedented public health crisis world-wide with threats that are ever growing, particularly for persons living in coastal locations. Health risks to mothers and children are a particular concern with growing evidence of impacts of elevated temperatures on maternal and child health. Whereas relatively few investigations have explored differential impacts of temperature among Black, Brown, and Indigenous mothers, the evidence for racial/ethnic disparities in perinatal health is overwhelming and disturbingly long-standing. Further, minority and low-income families experience a “double jeopardy” because of exposures to both chemical and non-chemical stressors in multiple environments. To address these inequities, the Maternal and Infant Environmental Health Riskscape (MIEHR) Research Center, an NIMHD/NIEHS/NICHD P50 Center of Excellence on Environmental Health Disparities Research was established to elucidate contributions of the biological, physical, social, and built environments of the environmental riskscape to environmental health disparities in Black and White pregnant women and their infants. The MIEHR Center has two synergistic research projects: Project 1: The Environmental Riskscape, Disasters and Obstetric Outcomes, an epidemiological study to identify race-specific associations between exposures to a mixture of chemicals and place-based stressors and preterm birth and Project 2: Disparities Aware Classifiers for Maternal and Infant Health, a bioinformatics study to develop and validate disparity aware classifiers for preterm birth for Black and White women. In support of both projects, we are recruiting women who present for labor and delivery at obstetric hospitals in the Texas Medical Center (TMC), the largest medical center in the world. The TMC is in greater Houston, which has an immensely diverse population in terms of racial/ethnic profiles as well as an economic duality of wealth and poverty. Further, the area experiences extremely hot and humid summers and, with its proximity to the Gulf Coast, is prone to hurricanes and flooding. By leveraging the MIEHR Center infrastructure and building on our prior work applying distributed lag non-linear models (DLNLMs) for modeling exposures that have non-linear and lagged effects, we propose to evaluate associations between rising temperatures and birth weight, a perinatal outcome that increases health risks of infants throughout their life course. The Specific Aims are to: 1) Expand the MIEHR environmental riskscape and compile time series of measurements of temperature and other meteorological variables during pregnancy for study participants; 2) Apply DLNLMs to investigate critical windows of exposure to temperature and birth weight; and 3) Examine whether maternal age, race, and place-based stressors modify associations between elevated temperature and birthweight. Results will lay the groundwork for including climate hazards as a critical element of the environmental riskscape in current MIEHR Center research projects and, in a new analysis, identify susceptible windows of exposure to high temperatures on birthweight that will inform efforts to protect pregnant women from heat exposure in the future.