Dissecting the causal impact of prenatal HIV exposure and the postnatal environment on development in Malawian Infants

剖析产前艾滋病毒暴露和产后环境对马拉维婴儿发育的因果影响

• 批准号: 10762850
• 负责人: Andrea G. Buchwald
• 金额: $ 15.57万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10762850
• 关键词: 5 year old; Accounting; Address; Africa South of the Sahara; Age; Area; Bioinformatics; Biological; Biostatistical Methods; Birth; Blood specimen; Child; Child Development; Child Health; Childhood; Clinic; Cohort Studies; Communicable Diseases; Complex; Data; Data Set; Data Sources; Development; Development Plans; Dimensions; Enrollment; Environment; Environmental Risk Factor; Epidemiologist; Equation; Etiology; Evaluation; Exposure to; Faculty; Flow Cytometry; Frequencies; Goals; Growth; HIV; HIV Infections; HIV-exposed uninfected infant; Health; Home environment; Immune; Immunity; Immunologic Markers; Immunologics; Immunology; Impairment; Infant; Infant Development; Infant Health; Infection; Infectious Disease Epidemiology; Infectious Diseases Research; Inflammation; Inflammatory; Interdisciplinary Study; Intervention; Language Development; Leadership; Life; Machine Learning; Malawi; Maryland; Maternal and Child Health; Measures; Mental Health; Mentors; Methodological Studies; Methodology; Methods; Modeling; Mother-Child Relations; Mothers; Motor; Nature; Neonatal; Neurocognitive; Neurocognitive Deficit; Outcome; Pregnancy; Principal Investigator; Productivity; Public Health; Research; Research Methodology; Research Personnel; Risk; Second Pregnancy Trimester; Severity of illness; Social Behavior; Socioeconomic Status; T-Lymphocyte; Techniques; Testing; Training; Umbilical Cord Blood; Universities; arm; career; career development; causal model; cohort; complex data; data integration; design; disease transmission; diverse data; early childhood; effective intervention; efficacious intervention; examination questions; executive function; follow-up; global health; immunological status; improved; innovation; interdisciplinary approach; large datasets; maternal wellbeing; medical schools; multidisciplinary; neonatal immunity; neurodevelopment; novel; postnatal; prenatal; prenatal exposure; psychosocial; skills; therapy design; transmission process

PROJECT SUMMARY/ABSTRACT Infant health and neurodevelopment in early life may be impaired by a wide range of prenatal and postnatal factors including maternal infection and inflammation, and the socio-behavioral postnatal environment. Identifying the independent impact of these exposures is critical for defining key interventions to improve infant health and development. This proposal addresses a long-standing challenge in examining multifactorial outcomes such as neurocognitive development that require incorporating both biological and psychosocial exposures. The Principal Investigator, Dr. Andrea Buchwald, is an infectious disease epidemiologist at University of Maryland School of Medicine with expertise in biostatistical methods and global health. She will use multidisciplinary methodology to address this challenge, examining the independent contributions of prenatal and postnatal exposures on child health and development in a cohort including HIV exposed and uninfected infants. Using data from an on-going cohort study in Malawi, Dr. Buchwald will be uniquely able to develop an innovative statistical approach to examine the contribution of both biological and socio-behavioral factors on infant health and development. Mothers with and without HIV infection were enrolled in their second trimester of pregnancy and infants are being followed up through five years of age for health and development outcomes. Dr. Buchwald will use a multidisciplinary approach, combining machine learning and structural equation modeling, to address the following aims: Aim 1: Estimate the independent contributions of in utero exposure to HIV and postnatal environmental factors on infant health and neurocognitive development. Aim 2: Identify immunological profiles at birth predictive of infant health and neurocognitive development. The results of this research will help us to identify key intervention targets for improving child health and development, to inform intervention design and implementation. Dr. Buchwald’s goal is to become an independent investigator in in pediatric infectious disease, with expertise in utilizing cross-disciplinary methodology to address the multifactorial nature of infectious disease. Towards this goal, she proposes a comprehensive career development plan that will enhance her existing skills in infectious disease epidemiology while providing mentored training in 1) data integration of large datasets, 2) socio-behavioral methodology, 3) analyzing large biological datasets, and 4) leadership skills. Dr. Buchwald has assembled a highly accomplished multidisciplinary team of mentors with unique areas of expertise including global health research, maternal/child health, neonatal immunology, bioinformatics, structural equation modeling, and neurodevelopment. Her mentors have a track record of successfully mentoring trainees and junior faculty and the University of Maryland School of Medicine will provide the ideal environment for Dr. Buchwald to establish a productive independent research career.

项目总结/摘要 婴儿的健康和早期的神经发育可能会受到各种产前和产后因素的影响。 因素包括母体感染和炎症，以及社会行为产后环境。 确定这些暴露的独立影响对于确定改善婴儿健康的关键干预措施至关重要。 健康和发展。这一建议解决了在审查多因素影响方面的一个长期挑战， 需要结合生物学和心理社会学的结果，例如神经认知发展 暴露。首席研究员Andrea Buchwald博士是一名传染病流行病学家， 马里兰州大学医学院，在生物统计方法和全球健康方面具有专长。她将 使用多学科方法来应对这一挑战，审查独立的贡献， 产前和产后暴露对儿童健康和发育的影响 未感染的婴儿利用马拉维正在进行的队列研究的数据，Buchwald博士将能够独特地 开发一种创新的统计方法，以检查生物和社会行为的贡献 影响婴儿健康和发育的因素。有和没有艾滋病毒感染的母亲参加了他们的第二次 对怀孕三个月和婴儿的健康和发育情况进行跟踪，直至五岁 结果。Buchwald博士将使用多学科方法，结合机器学习和结构 方程建模，以实现以下目标： 目标1：估计子宫内暴露于艾滋病毒和产后环境因素的独立作用 对婴儿健康和神经认知发育的影响。 目的2：确定出生时预测婴儿健康和神经认知发育的免疫学特征。 这项研究的结果将有助于我们确定改善儿童健康的关键干预目标， 开发，为干预措施的设计和实施提供信息。 Buchwald博士的目标是成为儿科传染病的独立研究者， 在利用跨学科的方法，以解决传染病的多因素性质的专业知识。 为了实现这一目标，她提出了一个全面的职业发展计划，以增强她现有的 传染病流行病学的技能，同时提供以下方面的指导培训：1）大型 数据集，2）社会行为方法，3）分析大型生物数据集，4）领导技能。 Buchwald博士组建了一个非常有成就的多学科导师团队， 专业领域包括全球卫生研究、孕产妇/儿童健康、新生儿免疫学， 生物信息学、结构方程模型和神经发育。她的导师有着 成功地指导学员和初级教师和马里兰州医学院的大学将 为Buchwald博士提供理想的环境，以建立一个富有成效的独立研究生涯。