Coronary Heart Disease in Black Women: The Role of Adverse Pregnancy Outcomes

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PROJECT SUMMARY This proposed five-year career development period will be used for research and training activities that will give Dr. Samantha Parker the skills and experience necessary to become an independent investigator. Dr. Parker’s long-term career goal is to apply the theory and analytical tools of life course epidemiology to the study of adverse pregnancy outcomes and risk of maternal cardiovascular disease. Building on a strong background in reproductive epidemiology and epidemiologic methods, Dr. Parker has proposed content area training in cardiovascular epidemiology and applied skills of statistical methods for life course epidemiology, including mediation analysis. She has also included training regarding social determinants of health to learn about individual-level and neighborhood-level social determinants as they relate to adverse pregnancy outcomes and cardiovascular disease. The training plan involves formal coursework, symposia and workshops, and didactic experiences and the establishment of a mentoring panel representing expertise in each training domain. The research aims are to investigate the association between adverse pregnancy outcomes and maternal risk of coronary heart disease (CHD) in the Black Women’s Health Study, the largest cohort study of black women in the United States. An accumulating body of evidence on this topic exists in predominantly white populations, but there is a dearth of evidence among black populations, despite persistent racial disparities in CHD morbidity and mortality. The aims will also address mediation by clinical risk factors for CHD, including chronic hypertension and diabetes, and modification by life course measures of individual-level and neighborhood-level social determinants of health.