Maternal and Developmental Risks from Environmental and Social Stressors (MADRES)

项目总结/摘要 全球人口正在经历前所未有的极端天气事件、气温升高， 以及气候变化导致的自然灾害，而气候变化又加剧了环境风险的影响 在已经脆弱的社区，增加易感性，扩大现有的健康差距。安装 有证据表明，极端温度和热应激可能会广泛影响心脏代谢和精神 然而，这些机制尚未得到很好的理解。越来越多的证据表明怀孕 是暴露于环境损害的一个脆弱窗口，对以后的孕产妇健康产生影响。同样，怀孕 人们被认为是最容易受到气候变化和热应激影响的群体， 社会弱势群体和历史上被边缘化的群体。然而，短期和长期的影响 怀孕期间暴露于气候引起的极端温度和热应激对产妇 心脏代谢和心理健康结果尚未得到深入研究。我们假设产前 暴露于热应激与更大的母体心脏代谢并发症和抑郁症有关。 怀孕期间和怀孕后的症状。我们建议检查这一假设和以下具体 MADRES队列中的412名产妇参与者的目标-一个主要是低收入西班牙裔的队列 洛杉矶的参与者。目的1将检查产前暴露于热应激（湿球地球仪）是否 温度，WGBT）与母体心脏代谢妊娠并发症（例如，妊娠 高血压，先兆子痫）和产后心脏代谢健康指数（血压，血脂谱， HbA 1c、BMI、腰臀比）;目标2将检查产前热应激暴露（WGBT）是否 与母亲在怀孕期间的抑郁症和产后抑郁症状使用中心 流行病学抑郁量表（CES-D）。目的3将探讨热休克蛋白（HSP） 是热暴露和生物适应热应激的早期和晚期的潜在有用的生物标志物 怀孕这项研究的结果将有助于为旨在减轻影响的规划工作和政策提供信息 城市地区的极端高温。

PROJECT SUMMARY/ABSTRACT The global population is experiencing unprecedented rates of extreme weather events, elevated temperatures, and natural disasters due to climate change, which in turn are compounding effects of environmental exposures in already vulnerable communities, increasing susceptibility, and widening existing health disparities. Mounting evidence suggests that extreme temperatures and heat stress may broadly influence cardiometabolic and mental health outcomes yet, the mechanisms are not well understood. Increasingly, evidence suggests that pregnancy is a vulnerable window of exposure to environmental insults for later maternal health effects. Similarly, pregnant people are considered among the most vulnerable to the effects of climate change and heat stress, as are socially disadvantaged and historically marginalized populations. However, the short and long-term effects of exposure to climate-induced extreme temperatures and heat stress during pregnancy on maternal cardiometabolic and mental health outcomes have not been investigated in depth. We hypothesize that prenatal exposure to heat stress is associated with greater maternal cardiometabolic complications and depressive symptoms both during and after pregnancy. We propose to examine this hypothesis and the following specific aims in 412 maternal participants in the MADRES cohort—a cohort of predominantly low-income Hispanic participants in Los Angeles. Aim 1 will examine whether prenatal exposure to heat stress (wet bulb globe temperature, WGBT) is associated with maternal cardiometabolic pregnancy complications (e.g., gestational hypertension, preeclampsia) and postpartum cardiometabolic health indices (blood pressure, lipid profiles, HbA1c, BMI, waist-to-hip ratio); Aim 2 will examine whether prenatal exposure to heat stress (WGBT) is associated with maternal depression during pregnancy and postpartum depressive symptoms using the Center for Epidemiologic Studies-Depression (CES-D) Scale. Aim 3 will explore whether heat shock proteins (HSPs) are potentially useful biomarkers of heat exposure and biological adaptation to heat stress in early and late pregnancy. Findings from this study will help inform planning efforts and policies aimed at mitigating the impacts of extreme heat in urban areas.