Pregnancy and perinatal complications and mortality: Collaborative Perinatal Project mortality linkage study

妊娠和围产期并发症和死亡率：协作围产期项目死亡率关联研究

• 批准号: 10684579
• 负责人: Edwina Yeung
• 金额: $ 9.04万
• 依托单位: EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10684579
• 关键词: 7 year old; Address; African American population; Archives; Asian; Behavior; Birth; Blood specimen; Cardiovascular Diseases; Cause of Death; Cessation of life; Characteristics; Child; Data; Enrollment; Epidemiology; European; Event; Gestational Diabetes; Goals; Gravid; Health; Hispanic; Hormones; Interview; Kidney Diseases; Link; Malignant Neoplasms; Maternal Mortality; Maternal Physiology; Medical History; Metabolism; Microfilm; Participant; Perinatal; Perinatal mortality demographics; Population; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy loss; Premature Birth; Prospective, cohort study; Race; Records; Research; Series; Socioeconomic Status; Stress; Universities; Woman; cardiovascular disorder risk; clinical center; demographics; disorder risk; follow-up; health record; hemodynamics; insight; mortality; neonatal outcome; novel; perinatal complications; pregnancy health; success

o Pregnancy is a common event that imposes significant stresses on maternal physiology, with substantive changes in metabolism, hemodynamics, and hormone levels that can expose underlying disease risks for women. While studies linking pregnancy events to mortality have been feasible using nationally linked health records in European nations, such linkages are less common in the US. Detailed pregnancy records with the ability to be linked to the NDI, which provides valuable cause of death information, were previously lacking. This presents a major data gap, as the US population has a different race/ethnic make-up, in particular African Americans who are known to have an increased risk for cardiovascular diseases and earlier death compared to whites. To address this gap, the CPP Mortality Linkage Study linked women who participated in the CPP with the NDI. The CPP was a prospective cohort study of 48,197 women with 55,908 pregnancies and 54,390 births at 12 university clinical centers across the US from 1959-1965. Detailed information on demographics, medical history, socioeconomic status, and behavior were collected via interviews at enrollment. Physical exams were performed, and blood samples collected throughout pregnancy. Children were followed to age 7 years. Approximately 46.2% of the enrolled women were white, 46.0% were black, 6.8% were Hispanic, and 1% of Asian or other descent. Progress Personal identifying data was successfully abstracted on 46,428 (97%) CPP participants from the original participant records archived in microfiche. The linkage with the NDI was completed in 2017. Using the NDI, a total of 35% of participants were identified as deceased as of 2016, which was consistent with an expected mortality of 39%. Initial analyses demonstrated the success of the linkage (Pollack and Hinkle et al. Epidemiology 2020), which opens doors to a series of research on lifelong health implications of pregnancy conditions. The successful linkage of the Collaborative Perinatal Project with mortality records offers a unique opportunity for insight on associations between gravid conditions and the longest follow up of mortality for U.S. women. Novel findings were identified, and multiple projects are ongoing to investigate long-term health implications of pregnancy health conditions by linking pregnancy health and events (e.g., gestational diabetes, preeclampsia, preterm birth, pregnancy loss, placental characteristics) to causes of maternal death 50+ years later (e.g., cardiovascular disease, cancer, and renal diseases).

O 妊娠是一种常见的事件，对母体生理产生重大压力，代谢，血液动力学和激素水平发生实质性变化，可能会暴露女性潜在的疾病风险。虽然将妊娠事件与死亡率联系起来的研究在欧洲国家使用全国性的健康记录是可行的，但这种联系在美国并不常见。以前缺乏能够与NDI联系起来的详细怀孕记录，NDI提供了有价值的死因信息。这是一个重大的数据缺口，因为美国人口有不同的种族/民族构成，特别是非洲裔美国人，与白人相比，他们患心血管疾病的风险增加，死亡率更高。为了弥补这一差距，CPP死亡率关联研究将参加CPP的妇女与NDI联系起来。 CPP是一项前瞻性队列研究，研究对象为1959-1965年美国12所大学临床中心的48，197名女性，其中55，908例妊娠和54，390例分娩。通过入组时的访谈收集有关人口统计学、病史、社会经济地位和行为的详细信息。进行体格检查，并在整个妊娠期间收集血液样本。孩子们被跟踪到7岁。约46.2%的入组女性为白色，46.0%为黑人，6.8%为西班牙裔，1%为亚裔或其他血统。 从缩微胶片中存档的原始参与者记录中成功提取了46，428（97%）名CPP参与者的个人识别数据。与NDI的联系于2017年完成。使用NDI，截至2016年，共有35%的参与者被确定为死亡，这与39%的预期死亡率一致。初步分析证明了这种联系的成功（Pollack和Hinkle等人，流行病学，2020年），这为一系列关于妊娠状况终身健康影响的研究打开了大门。围产期合作项目与死亡率记录的成功联系为深入了解妊娠状况与美国妇女死亡率最长随访之间的关联提供了独特的机会。发现了新的发现，多个项目正在进行中，通过将妊娠健康与事件（例如，妊娠期糖尿病、先兆子痫、早产、妊娠丢失、胎盘特征）到50+年后产妇死亡的原因（例如，心血管疾病、癌症和肾脏疾病）。