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.

项目摘要/摘要 婴儿早期的健康和神经发育可能会因出生前和出生后的各种因素而受损 这些因素包括母体感染和炎症，以及出生后的社会行为环境。 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 健康与发展。这项建议解决了多因素研究中长期存在的挑战 结果，如神经认知发展，需要将生物学和心理社会结合起来 曝光。首席调查员Andrea Buchwald博士是传染病流行病学家， 马里兰大学医学院，拥有生物统计学方法和全球卫生方面的专业知识。她会的 使用多学科方法来应对这一挑战，审查 队列中产前和产后暴露对儿童健康和发育的影响，包括艾滋病毒暴露和 未受感染的婴儿。使用马拉维正在进行的一项队列研究的数据，布赫瓦尔德博士将能够独一无二地 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。感染和不感染艾滋病毒的母亲参加了第二次 对怀孕三个月的孕妇和婴儿进行为期五年的健康和发育跟踪。 结果。布赫瓦尔德博士将使用多学科方法，将机器学习和结构 方程建模，以解决以下目标： 目标1：评估宫内暴露于艾滋病毒和出生后环境因素的独立贡献 关于婴儿健康和神经认知发展的研究。 目的2：确定出生时免疫学特征对婴儿健康和神经认知发育的预测作用。 这项研究的结果将有助于我们确定改善儿童健康和 开发，为干预设计和实施提供信息。 布赫瓦尔德博士的目标是成为儿科传染病领域的独立研究员， 在利用跨学科方法解决传染病的多因素性质方面的专业知识。 为了实现这一目标，她提出了一项全面的职业发展计划，这将增强她现有的 掌握传染病流行病学的技能，同时提供1)大型数据集成方面的指导性培训 数据集，2)社会行为方法论，3)分析大型生物数据集，4)领导技能。 布赫瓦尔德博士组建了一支高度成功的多学科导师团队，拥有独特的 专业领域包括全球卫生研究、妇幼保健、新生儿免疫学、 生物信息学、结构方程建模和神经发育。她的导师在过去有过 成功地指导学员和初级教职员工以及马里兰大学医学院将 为布赫瓦尔德博士建立富有成效的独立研究事业提供理想的环境。