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.

项目概要/摘要 婴儿早期的健康和神经发育可能会受到一系列产前和产后的影响 因素包括产妇感染和炎症以及产后社会行为环境。 确定这些暴露的独立影响对于确定改善婴儿的关键干预措施至关重要 健康与发展。该提案解决了检查多因素方面长期存在的挑战 神经认知发展等结果需要结合生物学和心理社会 曝光。首席研究员 Andrea Buchwald 博士是一名传染病流行病学家 马里兰大学医学院拥有生物统计方法和全球健康方面的专业知识。她会 使用多学科方法来应对这一挑战，审查 队列中的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。利用马拉维正在进行的一项队列研究的数据，Buchwald 博士将能够独特地 开发创新的统计方法来检查生物和社会行为的贡献 影响婴儿健康和发育的因素。感染和未感染艾滋病毒的母亲都参加了第二次 正在对怀孕三个月和婴儿进行随访直至五岁，以确保健康和发育 结果。 Buchwald 博士将采用多学科方法，将机器学习和结构学习相结合 方程建模，以实现以下目标： 目标 1：估计子宫内艾滋病毒暴露和产后环境因素的独立影响 婴儿健康和神经认知发展。 目标 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。 这项研究的结果将帮助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， 利用跨学科方法来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，以增强她现有的能力 传染病流行病学技能，同时提供以下方面的指导培训：1）大型数据集成 数据集，2) 社会行为方法，3) 分析大型生物数据集，以及 4) 领导技能。 Buchwald 博士组建了一支卓有成就的多学科导师团队，具有独特的 专业领域包括全球健康研究、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。她的导师有以下记录 成功指导学员和初级教师，马里兰大学医学院将 为 Buchwald 博士建立富有成效的独立研究生涯提供了理想的环境。