Severe Maternal Morbidity: An Investigation of Racial-Ethnic Disparities, Social Disadvantage & Maternal Weight
严重的孕产妇发病率:对种族差异、社会弱势的调查
基本信息
- 批准号:10660008
- 负责人:
- 金额:$ 60.08万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2018
- 资助国家:美国
- 起止时间:2018-01-19 至 2028-03-31
- 项目状态:未结题
- 来源:
- 关键词:AddressAffectAnemiaBirthBlack AmericanBody mass indexCaliforniaCensusesCesarean sectionChildCommunitiesCountryDataDeath CertificatesDisparityEducationEnsureEquityEthnic OriginExclusionFetal DeathHealthHealthcareHemorrhageHospitalsHypertensionIncomeIndividualInequalityInequityInfectionInterventionInvestigationJointsKnowledgeLife Cycle StagesLinkLive BirthMasksMaternal HealthMaternal MortalityMediationMedicalMethodsMorbidity - disease rateMothersMultiple PregnancyNative AmericansNeighborhoodsNew JerseyOrgan failureOutcomeOutcome StudyPersonsPhasePopulationPopulation ResearchPostpartum PeriodPovertyPregnancyPrevention strategyProxyRaceRecordsRecurrenceResearchResourcesRiskRisk AssessmentRisk FactorsRisk ReductionSepsisSocial EnvironmentSocial IdentificationSurvivorsTimeTranslatingTranslationsVirginiaWomanWorkcommunity engagementcommunity organizationsdata resourcedisparity eliminationethnic disparityhealth disparityhigh riskimprovedintersectionalitylarge scale datalongitudinal datasetmarginalizationmaternal morbiditymaternal outcomematernal weightneighborhood disadvantagenext generationparent grantpeople of colorpregnancy disorderpregnancy healthpregnantprepregnancyracial disparityreproductivesegregationsevere maternal morbiditysocialsocial disparitiessocial structuresocioeconomicssuccess
项目摘要
ABSTRACT
Severe maternal morbidity (SMM), which encompasses conditions that put pregnant people most at risk
of dying (e.g., hemorrhage, sepsis, organ failure), doubled in the last two decades. The most common
precursors to SMM – anemia, hypertensive disorders of pregnancy (HDP), and cesarean birth – are also
increasing. People of color, especially Black and Native American people, are at increased risk for all
these outcomes. This Renewal proposal builds on our prior work to address inequities in maternal
outcomes. Via the Parent Grant, our team enhanced current understanding of the contribution of social
context (focusing on neighborhood social disadvantage) and maternal pre-pregnancy health (focusing on body
mass index) to SMM risk, using a unique data resource we built of California (CA) births. This Renewal uses
theoretically grounded approaches to address several remaining gaps in our understanding of maternal health
in the U.S. that were illuminated by the Parent Grant. We will build a unique resource of 16 million births in
three states from 1997-2021. The dataset longitudinally links vital records (live birth and fetal death certificates)
with hospital discharge data for mother and baby; includes residential address; and links data for repeat
pregnancies to the same person over time, thus providing the type of large-scale data with high-quality
information on maternal health and social context that the field needs to advance population-level research on
maternal health. All phases of the research will be guided by a community advisory board (CAB). Using an
intersectionality framework, Aim 1 will examine joint impacts of multiple forms of marginalization on SMM, its
subtypes (i.e., hypertension-, hemorrhage-, and sepsis-related SMM), and its precursors (i.e., HDP, anemia,
mode of birth). Indicators of marginalization include race-ethnicity, education, health care payer, nativity, and
census tract-level markers of social disadvantage and structural inequality (e.g., poverty, segregation). Using a
reproductive life-course framework, Aim 2 will determine the cumulative impact of social and medical risk
factors across successive pregnancies on maternal health (i.e., SMM, SMM subtypes, SMM precursors). We
will examine how factors related to social context (e.g., persistent census tract poverty), morbidity (e.g.,
persistent HDP), and mode of birth (primary cesarean birth) affect subsequent occurrence and recurrence of
the study outcomes. Aim 3 will use findings from Aims 1 and 2 to identify and prioritize strategies to improve
maternal health and equity. We will use a) causal inference methods (mediation and g-computation) to
understand mechanisms and compare the potential impact of selected hypothetical interventions on study
outcomes and disparities, and b) community-engaged prioritization methods to synthesize our findings and
prioritize next steps. By understanding risks across multiple forms of marginalization and successive
pregnancies, and guided by rigorous analytics and community-grounded knowledge, our work will contribute to
advancing the next generation of actionable population-level SMM equity research.
摘要
项目成果
期刊论文数量(0)
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{{ truncateString('SUZAN L CARMICHAEL', 18)}}的其他基金
Stanford PRIHSM: PReventing Inequities in Hemorrhage-related Severe Maternal Morbidity
斯坦福大学 PRIHSM:预防与出血相关的严重孕产妇发病率的不平等
- 批准号:
10748636 - 财政年份:2023
- 资助金额:
$ 60.08万 - 项目类别:
Building a causal pathway framework to identify interventions to eliminate racial/ethnic disparities in severe maternal morbidity
建立因果路径框架,以确定消除严重孕产妇发病率方面的种族/民族差异的干预措施
- 批准号:
10684599 - 财政年份:2022
- 资助金额:
$ 60.08万 - 项目类别:
Building a causal pathway framework to identify interventions to eliminate racial/ethnic disparities in severe maternal morbidity
建立因果路径框架,以确定消除严重孕产妇发病率方面的种族/民族差异的干预措施
- 批准号:
10656523 - 财政年份:2021
- 资助金额:
$ 60.08万 - 项目类别:
Building a causal pathway framework to identify interventions to eliminate racial/ethnic disparities in severe maternal morbidity
建立因果路径框架,以确定消除严重孕产妇发病率方面的种族/民族差异的干预措施
- 批准号:
10280836 - 财政年份:2021
- 资助金额:
$ 60.08万 - 项目类别:
Building a causal pathway framework to identify interventions to eliminate racial/ethnic disparities in severe maternal morbidity
建立因果路径框架,以确定消除严重孕产妇发病率方面的种族/民族差异的干预措施
- 批准号:
10878197 - 财政年份:2021
- 资助金额:
$ 60.08万 - 项目类别:
Building a causal pathway framework to identify interventions to eliminate racial/ethnic disparities in severe maternal morbidity
建立因果路径框架,以确定消除严重孕产妇发病率方面的种族/民族差异的干预措施
- 批准号:
10490296 - 财政年份:2021
- 资助金额:
$ 60.08万 - 项目类别:
Severe Maternal Morbidity: An Investigation of Racial-Ethnic Disparities, Social Disadvantage & Maternal Weight
严重的孕产妇发病率:对种族差异、社会弱势的调查
- 批准号:
10087967 - 财政年份:2018
- 资助金额:
$ 60.08万 - 项目类别:
Severe Maternal Morbidity: An Investigation of Racial-Ethnic Disparities, Social Disadvantage & Maternal Weight
严重的孕产妇发病率:对种族差异、社会弱势的调查
- 批准号:
10300988 - 财政年份:2018
- 资助金额:
$ 60.08万 - 项目类别:
Severe Maternal Morbidity: An Investigation of Racial-Ethnic Disparities, Social Disadvantage & Maternal Weight
严重的孕产妇发病率:对种族差异、社会弱势的调查
- 批准号:
10091301 - 财政年份:2018
- 资助金额:
$ 60.08万 - 项目类别:
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