Climate Change Impacts on Maternal Health in a Southern Birth Cohort: A Causal Analysis

气候变化对南方出生队列孕产妇健康的影响：因果分析

基本信息

批准号：
10689015
负责人：
Jennifer Runkle
金额：
$ 6.94万
依托单位：
NORTH CAROLINA STATE UNIVERSITY RALEIGH
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-08-23 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10689015
关键词：
Acute Air American College of Obstetricians and Gynecologists Area Birth Black race Centers for Disease Control and Prevention (U.S.)Chronic Climate Communities County Data Disparity Environmental Exposure Environmental Health Ethnic Population Event Exhibits Exposure to Floods Foundations Future Generations Goals Green space Health Healthcare Heat Waves Human Hurricane Individual Infant Health International Intervention Knowledge Life Link Literature Maternal Health Maternal Mortality Measures Medical Medical Care Costs Monitor Mothers Multiple Pregnancy National Institute of Environmental Health Sciences Neighborhoods Newly Diagnosed Outcome Pathway interactions Patients Pattern Phase Poverty Predisposition Pregnancy Pregnancy Complications Pregnancy Outcome Pregnant Women Process Psychological Stress Recovery Relative Risks Research Risk Science Social Environment Societal Factors Strategic Planning Structural Racism Subgroup Temperature Testing Underweight United States National Institutes of Health Woman Work age group black women care burden career climate change climate crisis climate impact climate-related health cohort comparison control design disorder risk efficacy evaluation environmental stressor extreme heat hazard health disparity health inequalities improved innovation maternal morbidity maternal risk premature prenatal protective factors racial difference racial disparity racial population residential segregation resilience response severe maternal morbidity social social stressor stillbirth stress disorder stressor women faculty

项目摘要

PROJECT SUMMARY The American College of Obstetricians and Gynecologists recognizes that climate change is a significant health concern for pregnant women. Pregnancy is an understudied critical window, and few studies have examined the impact of the climate crisis on pregnant women and their unborn. Severe Maternal Morbidity (SMM) is currently a surveillance indicator used by the Centers for Disease Prevention and Control to measure and monitor improvements in maternal health; however, it has yet to be used in the context of climate change. SMM is a composite of 21 life-threatening conditions that arise during the process of labor and delivery. These conditions are known as “near miss” complications (i.e., an event in which a woman nearly dies) that result in significant medical care burden, including newly diagnosed chronic health conditions, psychological stress disorders, and amplified risks of maternal deaths. Black women are 2 times more likely to suffer from these life- threatening pregnancy complications, and the environmental causes of this important disparity are largely unknown and underexplored. An important science gap remains in identifying measures that elucidate climate and maternal health inequities, particularly for understanding the relationship between climate change and pregnancy risks among Black women in the South. This project will use a retrospective birth cohort to explore the causal linkages between the upstream social and environmental stressors and climate-related changes in maternal morbidity. Our long-term goal is to develop patient and healthcare interventions to reduce the impact of climate change during pregnancy. The overarching objectives of this exploratory study is to examine climate-sensitivity in SMM risk and advance understanding of the social-environmental drivers of racial inequalities in maternal morbidity. We will address this research gap with the following two specific aims: Aim 1. Examine patterns in SMM rates in response to three climate hazards--extreme heat, hurricanes, and inland flooding for a Southern birth cohort; Aim 2. Characterize the individual and neighborhood-level social (e.g., poverty, residential segregation) and environmental (e.g., greenspace) determinants that drive maternal health disparities in a changing climate. At the completion of this project, our expected outcomes are to 1) understand how the rate of SMM differs across different climate hazards and 2) elucidate the causal pathways linking climate change and maternal morbidity. The proposed research is significant because results will extend beyond identifying disease risks to capturing protective factors, as well as aid in hypothesis generation around pathways that contribute towards causal inference. This contribution is innovative since proposed results will provide new knowledge and a necessary first step in furthering understanding of the impacts of climate change on maternal health, providing the foundation for future studies on maternal health interventions and needed adaptations to climate change.

项目摘要美国产科医生和妇科学家认识到气候变化是重大的对孕妇的健康关注。怀孕是一个关键的窗口，很少有研究检查了气候危机对孕妇及其未出生的影响。严重的母亲发病率（SMM）目前是疾病预防和控制中心使用的监视指标，以衡量并监测孕产妇健康的改善；但是，它尚未在气候变化的背景下使用。 SMM是在劳动和分娩过程中出现的21种威胁生命状况的综合。这些条件被称为“接近小姐”并发症（即女人几乎死亡的事件）导致大量医疗保健伯恩（Burnen），包括新诊断的慢性健康状况，心理压力疾病，并放大了孕产妇死亡的风险。黑人妇女遭受这些生活的可能性高两倍 - 威胁怀孕并发症以及这种重要差异的环境原因很大程度上是未知且未忽视。在识别阐明气候和物物健康的测量方面仍然存在一个重要的科学差距不平等，特别是为了了解气候变化与怀孕风险之间的关系南部的黑人妇女。该项目将使用回顾性出生队列来探索因果关系在上游社会和环境压力源以及与气候相关的孕产妇发病率变化之间。我们的长期目标是发展患者和医疗干预措施以减少气候变化的影响怀孕期间。这项探索性研究的总体目标是检查气候敏感性在SMM风险和提前理解社会环境驱动力的种族询问驱动力中孕产妇发病率。我们将以以下两个具体目的解决这一研究差距：目标1。响应三种气候危害的SMM率的模式 - 高温，飓风和内陆洪水南方生日队列；目标2。描述个人和社区层面的社会（例如，贫困，居民种族隔离）和环境（例如，绿色空间）确定驱动物质健康气候不断变化的差异。该项目完成后，我们的预期结果是1）了解 SMM的速率在不同的气候危害中的不同以及2）阐明与因果关系的途径气候变化和母性发病率。拟议的研究很重要，因为结果将扩展除了确定疾病的风险以捕获受保护的因素，还可以帮助假设产生有助于因果推断的途径。此贡献是创新的，因为提出的结果将提供新知识和进一步了解攀登影响的必要第一步改变孕产妇的健康，为未来的孕产妇健康干预措施的研究奠定了基础需要适应气候变化。