An internet-based preconception cohort study in North America

北美基于互联网的孕前队列研究

基本信息

批准号：
10680455
负责人：
LAUREN A WISE
金额：
$ 67.87万
依托单位：
BOSTON UNIVERSITY MEDICAL CAMPUS
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-14 至 2027-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10680455
关键词：
3-Dimensional Acute Adult Affect American Area Assisted Reproductive Technology Biological Markers Black race Buffers Child Chronic Cohort Studies Collection Conceptions Couples Data Discrimination Emotional Enrollment Ensure Ethnic Origin Etiology Female Financial Hardship Geography Hair Health Care Costs Health Services Accessibility Heterogeneity Hour Hydrocortisone Indigenous Infertility Infrastructure Internet Intervention Joints Life Life Cycle Stages Low Income Population Measures Mediating National Institute of Child Health and Human Development North America Occupational Occupations Online Systems Outcome Participant Patient Recruitments Patient Self-Report Perinatal Physiological Pilot Projects Pittsburgh Sleep Quality Index Population Pregnancy Pregnancy loss Prospective Studies Prospective cohort Prospective, cohort study Public Health Race Reproductive Health Research Risk Risk Factors Rotation Salivary Sampling Selection Bias Sleep Sleep Fragmentations Sleep disturbances Social support Spontaneous abortion Stratification Stress Teenagers Underrepresented Populations United States Woman Work actigraphy adverse childhood events aged alpha-amylase childhood adversity coronavirus disease cost cost efficient design ethnic disparity experience fitbit follow-up health goals high risk infertility treatment male men modifiable risk novel occupational stressor people of color perceived stress perinatal outcomes poor sleep public health intervention racial discrimination racial disparity racism recruit reproductive reproductive outcome shift work sleep health sleep onset sleep pattern sleep quality stressor subfertility success time-to-pregnancy treatment disparity

项目摘要

ABSTRACT About 15% of American couples experience infertility (time-to-pregnancy >12 months) and more than 20% of couples experience spontaneous abortion (SAB, pregnancy loss <20 weeks of gestation). Fertility treatment is costly and inaccessible to most Americans, particularly people of color and low-income individuals. Among those with access to treatment, fertility treatment has relatively low success rates and is associated with adverse perinatal outcomes. There are also large racial/ethnic disparities in treatment success rates. As infertility and SAB exact an emotional and financial toll on affected couples, identifying modifiable risk factors for these outcomes in both partners is an important public health goal. With previous support from the NICHD, we designed a web-based prospective cohort study to recruit, follow, and collect comprehensive data on couples attempting pregnancy. Some of our strongest findings to date pertain to poor sleep quality and stress in both partners. To build on this work, we are submitting a renewal application (R01-HD086742) to evaluate the influence of understudied sleep- and stress-related exposures on subfertility and SAB risk, explore putative mechanisms of effect, and examine the extent to which these factors explain existing race/ethnic disparities in subfertility and SAB. Pregnancy Study Online (PRESTO) is a web-based preconception cohort study in North America that has enrolled more than 16,000 females and nearly 4,000 male partners during the preconception period, with 20% of PRESTO participants identifying as Black, Indigenous, or People of Color (BIPOC). In this renewal application, we propose to enroll an additional 8,000 females to enhance power for more detailed analyses of sleep using the Pittsburgh Sleep Quality Index, selected stressors (e.g., childhood adversity, discrimination, financial hardship, COVID-related factors), and risk of subfertility and SAB. We also propose to collect and analyze more objective exposure data using sleep actigraphy (Fitbit Inspire 2) and stress biomarkers (hair cortisol and salivary alpha-amylase) in a subset of new participants. We will enroll an additional 2,000 male partners to enhance power for examining male exposures and joint effects in both partners. To ensure power for key hypotheses (e.g., reproductive effects of racial discrimination), we will oversample BIPOC participants. This renewal application builds on our previous work indicating that stress and sleep quality are important determinants of reproductive health. Our expanded focus on understudied stressors—in populations that are underrepresented in reproductive and perinatal research (e.g., males and BIPOC)—is novel and of high public health importance. Preconception enrollment minimizes misclassification, selection bias, and reverse causation, and captures early SABs (<8 weeks of gestation), a priority area for NICHD. The cohort’s prospective design, cost-efficient web- based infrastructure for participant recruitment and follow-up, geographic and racial/ethnic heterogeneity, and comprehensive collection of confounder data in both partners are added strengths. Results will generate data that can inform public health interventions to reduce the population burden of subfertility and SAB.

抽象的约15％的美国夫妇经历不孕症（怀孕时间> 12个月），超过20％夫妻经历了赞助堕胎（SAB，妊娠损失<20周的妊娠）。生育治疗是大多数美国人，尤其是有色人种和低收入个人的人都昂贵且无法访问。其中通过获得治疗，生育治疗的成功率相对较低，并且与逆境有关围产期结果。治疗成功率也存在很大的种族/种族差异。作为不育症和确切地对受影响的夫妇造成情感和经济上的损失，确定这些可修改的风险因素双方的成果是一个重要的公共卫生目标。在NICHD的先前支持下，我们设计了一项基于网络的前瞻性队列研究，旨在招募，关注和收集有关夫妻的全面数据怀孕。迄今为止，我们的一些有力的发现与双方的睡眠质量和压力不佳有关。到在这项工作的基础上，我们提交了续订申请（R01-HD086742），以评估研究的睡眠和压力相关的有关亚生育性和SAB风险的暴露，探索假定的机制效应，并检查这些因素在多大程度上解释现有的种族/种族差异 sab。在线妊娠研究（PRESTO）是北美的基于网络的先选人群研究在先入期间，有超过16,000名女性和近4,000名男性伴侣，有20％ Presto参与者的识别为黑色，土著或有色人种（BIPOC）。在此续签应用中，我们建议再招募8,000名女性，以增强功率，以使用匹兹堡睡眠质量指数，选定的压力源（例如，儿童广告，歧视，财务苦难，与共同相关的因素），以及属于和SAB的风险。我们还建议收集和分析更多使用睡眠行为摄影（Fitbit Inspire 2）和压力生物标志物（毛皮质醇和唾液 α-淀粉酶）在新参与者的子集中。我们将再招募2,000个男性伴侣来增强检查男性暴露和双方关节影响的权力。确保关键假设的权力（例如，种族歧视的生殖效应），我们将过度采样BIPOC参与者。这个更新应用程序以我们以前的工作为基础，表明压力和睡眠质量是重要的决定者生殖健康。我们扩展的关注理解的压力源 - 人口不足的压力源在生殖和围产期研究（例如，男性和BIPOC）中，这是新颖的，并且具有很高的公共健康重要性。预先看法的入学率最大程度地减少了分类偏差，选择偏见和反向原因，并提早捕获 SABS（妊娠8周），NICHD的优先区域。该队列的潜在设计，成本效益的网络 - 基于参与者招募和后续活动，地理和种族/种族异质性的基础架构以及在两个合作伙伴中的混杂数据中的全面收集都添加了优势。结果将生成数据这可以告知公共卫生干预措施，以减少种群燃烧的副作用和SAB。

项目成果

期刊论文数量（69）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Invited Commentary: Interaction Between Diet and Chemical Exposures.

特邀评论：饮食与化学品暴露之间的相互作用。

DOI：
10.1093/aje/kwz152
发表时间：
2019
期刊：
American journal of epidemiology
影响因子：
5
作者：
Wesselink,AmeliaK;Hatch,ElizabethE;Wise,LaurenA
通讯作者：
Wise,LaurenA

Sexual dysfunction, distress, and care-seeking among females during the preconception period.

女性孕前期的性功能障碍、痛苦和寻求护理。

DOI：
10.1016/j.ajog.2023.03.037
发表时间：
2023
期刊：
American journal of obstetrics and gynecology
影响因子：
9.8
作者：
Bond,JuliaC;White,KatharineO;Abrams,JasmineA;Wesselink,AmeliaK;Wise,LaurenA
通讯作者：
Wise,LaurenA

Association of income and education with fecundability in a North American preconception cohort.

DOI：
10.1016/j.annepidem.2020.07.004
发表时间：
2020-10
期刊：
Annals of epidemiology
影响因子：
5.6
作者：
Schrager NL;Wesselink AK;Wang TR;Hatch EE;Rothman KJ;Mikkelsen EM;Boynton-Jarrett RD;Wise LA
通讯作者：
Wise LA

A prospective study of preconception asthma and spontaneous abortion.