Environmental chemical exposures during pregnancy and women's cardio-metabolic health

怀孕期间的环境化学物质暴露与女性心脏代谢健康

• 批准号: 10659017
• 负责人: Dana Dabelea
• 金额: $ 42.08万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10659017
• 关键词: Address; Adult; Affect; Air; Air Pollutants; Attention; Behavior; Behavioral; Birth; Body Composition; Body Weight; Body mass index; Breast Feeding; Cardiometabolic Disease; Cardiovascular Diseases; Characteristics; Chemical Exposure; Child; Child Health; Chronic Disease; Cohort Studies; Collaborations; Data; Data Collection; Diabetes Mellitus; Diet; Enrollment; Environment; Environmental Exposure; Environmental Impact; Evaluation; Event; Exposure to; Fatty acid glycerol esters; Flame Retardants; Funding; Gestational Diabetes; Glucose; Health; Hepatic; Infant Health; Joints; Life; Life Cycle Stages; Link; Longevity; Longitudinal Studies; Magnetic Resonance Imaging; Maternal Health; Measurement; Medical Records; Metabolic; Metal exposure; Metals; Modeling; Morbidity - disease rate; Mothers; National Institute of Environmental Health Sciences; OGTT; Obesity; Organophosphates; Outcome; Parabens; Participant; Persons; Phenols; Plethysmography; Poly-fluoroalkyl substances; Population; Postpartum Period; Pre-Eclampsia; Predisposition; Pregnancy; Pregnancy Outcome; Pregnant Women; Productivity; Records; Research; Research Personnel; Risk; Risk Factors; Role; Serum; Statistical Methods; Sturnus vulgaris; Time; Unhealthy Diet; Visit; Weight; Weight Gain; Woman; Women' s Group; Women' s Health; ambient air pollution; cardiometabolism; cardiovascular disorder risk; cohort; diabetes risk; disorder risk; environmental chemical; environmental chemical exposure; ethnic diversity; experience; fatty liver disease; follow-up; gestational weight gain; improved; lipid metabolism; maternal outcome; mortality; novel; obesity risk; offspring; phenotypic data; phthalates; pollutant; post pregnancy; postpartum weight; pregnancy hypertension; prevent; public health intervention; recruit; residence; risk mitigation; urinary

Project Summary While much research has been devoted to exploring the impact of environmental chemical exposures during pregnancy on infant and child health, relatively little attention has focused on the potential influence of these exposures on maternal health. Recent evidence suggests that pregnancy may be a sensitive period in the life course, during which chemical exposures may have long-lasting effects on cardio-metabolic disease risk among women. Using a well-characterized existing cohort study that enrolled 1,410 pregnant women in 2009- 2014, we propose the following aims: (1) quantify the relationship between environmental exposures during pregnancy and short-term maternal health outcomes including: postpartum weight retention, reduced breastfeeding initiation and duration, and incident diabetes; (2) quantify the relationship between environmental exposures during pregnancy and long-term maternal health outcomes: body composition, weight trajectories from pregnancy through ~10 years after parturition, hepatic fat, dysglycemia and incident diabetes, and cardiovascular disease; and (3) evaluate the potential role of maternal characteristics and behaviors during pregnancy, specifically obesity and diet quality, in modifying associations between environmental chemical exposures and outcomes. Exposures during pregnancy will include serum per- and polyfluoroalkyl substances (PFAS), urinary phthalate metabolites, phenols and parabens, metals, organophosphate flame retardants, and modeled air pollutants at the maternal residential address during pregnancy. We propose to recruit 700 of the original study participants to return for a follow-up visit at ~10 years postpartum. At this visit, participants will undergo a comprehensive metabolic health evaluation including body composition via air displacement plethysmography (BOD POD), dysglycemia via oral glucose tolerance test, and hepatic fat fraction via MRI. Medical records will be abstracted to document incident diabetes and cardiovascular disease, and to reconstruct body weight trajectories. We will estimate associations between exposures during pregnancy and maternal outcomes using covariate-adjusted multivariable regression models for continuous, binary, or time-to- event data, as appropriate. Exposures will be evaluated as single pollutants and as mixtures using advanced statistical methods including Bayesian Kernel Machine Regression and Bayesian hierarchical Cox survival models. We hypothesize that maternal body mass index prior to pregnancy and diet quality during pregnancy will modify the effects of environmental chemical exposures on cardio-metabolic outcomes, such that associations will be stronger among women with obesity entering pregnancy or with poor diet quality during pregnancy. The results of this study will inform public health interventions to identify women who may be especially susceptible to the effects of environmental chemical exposures during pregnancy, and to improve the environment of pregnancy to promote the long-term health of both the offspring and the mother.

项目摘要 虽然很多研究致力于探索在环境化学暴露期间的影响 对婴儿和儿童健康的怀孕，相对较少的关注集中在这些潜在影响上 暴露于孕产妇健康。最近的证据表明，怀孕可能是生活中敏感时期 当然，在此期间，化学暴露可能会对心脏代谢疾病风险产生长期影响 在女性中。使用一项良好的现有队列研究，该研究在2009年招募了1,410名孕妇 2014年，我们提出以下目的：（1）量化环境暴露之间的关系 怀孕和短期孕产妇健康结果，包括：产后体重，减少 母乳喂养的启动和持续时间以及入射糖尿病； （2）量化环境之间的关系 怀孕期间的暴露和长期孕产妇健康结果：身体成分，体重轨迹 从怀孕到分娩后约10年，肝脂肪，血糖和入射糖尿病，以及 心血管疾病； （3）评估母体特征和行为的潜在作用 怀孕，特别是肥胖和饮食质量，以修改环境化学之间的关联 暴露和结果。怀孕期间的暴露将包括血清人均和多氟烷基物质 （PFA），尿邻苯二甲酸盐代谢产物，苯酚和对羟基苯甲酸酯，金属，有机磷酸盐阻燃剂和 怀孕期间在孕产妇住宅地址建模空气污染物。我们建议招募700个 原始研究参与者将在产后约10年返回后续访问。在这次访问中，参与者将 进行全面的代谢健康评估，包括通过空气位移的身体组成 通过口服葡萄糖耐受性测试和通过MRI进行的肝脂肪分数，多生产量（BOD POD），血糖症。 病历将被摘要以记录事件糖尿病和心血管疾病，并 重建体重轨迹。我们将估计怀孕期间暴露与 使用协变量调整的多变量回归模型的孕产妇结局用于连续，二元或时间 事件数据，适当。暴露将作为单个污染物评估，并用高级评估 统计方法在内，包括贝叶斯内核机器回归和贝叶斯等级Cox生存 型号。我们假设怀孕期间怀孕和饮食质量之前的母体体重指数 将修改环境化学暴露对心脏代谢结果的影响，以便 肥胖女性进入怀孕或饮食质量较差的女性将更加强大 怀孕。这项研究的结果将告知公共卫生干预措施，以确定可能是 特别容易受到怀孕期间环境化学暴露的影响，并改善 怀孕的环境，以促进后代和母亲的长期健康。