Project 2: Maternal history of childhood sexual abuse and adverse perinatal outcomes: Harnessing novel ecological methods to understand mechanisms

项目 2：母亲童年性虐待史和不良围产期结局：利用新的生态方法来了解机制

• 批准号: 10090780
• 负责人: Margaret Bublitz
• 金额: $ 21.7万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-15 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10090780
• 关键词: Abruptio Placentae; Acute Liver Failure; Affect; American Heart Association; Appointment; Area; Autonomic nervous system; Biometry; Biosensor; Buffers; Cardiovascular system; Cellular Phone; Centers of Research Excellence; Child; Child Sexual Abuse; Childhood; Clinical; Data; Data Collection; Development; Diagnosis; Ecological momentary assessment; Exhibits; Fetal Growth Retardation; Fetal Movement; Functional disorder; Future; Gender; Infant; Interoception; Interruption; Intervention; Kidney Failure; Knowledge; Lead; Life; Link; Mediating; Methodology; Methods; Modeling; Morbidity - disease rate; Mothers; Neonatal Mortality; Neurologic; Outcome; Pathway interactions; Perception; Pregnancy; Prenatal care; Prevention; Process; Recording of previous events; Reporting; Research; Risk; Risk Factors; Role; Sampling; Sexual abuse; Social Environment; Social support; Source; Stress; Symptoms; Technology; Translating; Trauma; United States; Woman; Work; biological adaptation to stress; blood pressure regulation; bodily sensation; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular risk factor; experience; fetal; heart disease risk; in vivo; lifetime risk; maternal morbidity; maternal risk; mortality; neonatal morbidity; novel; obstetric care; perinatal outcomes; pregnancy disorder; premature; prenatal; prenatal experience; prevent; resilience; response; sound; stress management; therapy development; time use; wearable device; wearable sensor technology

PROJECT SUMMAY / ABSTRACT 1 in 5 women in obstetric care experienced sexual abuse in childhood. Women with histories of child sexual abuse are 2x more likely to experience hypertensive disorders of pregnancy (HDP), a leading cause of maternal and fetal morbidity and mortality in the United States. $2.18 billion is spent annually on treatment of affected mothers and infants in the year after delivery. In addition, HDP increases lifetime cardiac disease risk by 2-4X and is considered an independent, gender-specific cardiovascular risk factor by the American Heart Association. Identification of treatment targets for the prevention of HDP holds tremendous promise in the prevention of cardiovascular diseases later in life. Maternal history of child sexual abuse is hypothesized to increase risk for HDP through stress-induced activation of the autonomic nervous system. Routine prenatal experiences, including prenatal care appointments, pregnancy symptoms, and fetal movements, may be a significant source of stress for women with child sexual abuse histories as these experiences can serve as disturbing reminders of previous sexual abuse. Therefore, perceptions of bodily sensations (i.e., interoception), may trigger autonomic stress responses and increase risk for HDP among women with child sexual abuse histories. Conversely, consistent with the stress buffering model, supportive social context may interrupt interoceptive perceptions and decrease autonomic activation for women with child sexual abuse histories. The objective of the proposed study is to characterize interoceptive and autonomic responses to prenatal experiences as pathways to HDP in women with and without CSA histories, and to examine the moderating role of social context. We will use a novel methodological approach by integrating EMA, ambulatory biometric wearable technology, and electronically activated recorder (EAR) methods to rigorously assess daily interoceptive and autonomic responses to prenatal experiences across gestation. Results from this area of research are expected to have an important positive impact on the field because new knowledge may be used to select meaningful targets for interventions to regulate blood pressure and the development of HDP, and to prevent cardiovascular illness later in life.

项目总结/摘要 在接受产科护理的妇女中，每5人中就有1人在童年时期遭受过性虐待。有儿童性行为史的女性 2倍更有可能经历妊娠高血压疾病（HDP），这是导致妊娠高血压疾病的主要原因。 孕产妇和胎儿的发病率和死亡率在美国。每年花费21.8亿美元用于治疗 受影响的母亲和婴儿在分娩后的一年。此外，HDP会增加终身心脏病风险 2- 4倍，被美国心脏协会认为是一个独立的，性别特异性的心血管风险因素。 协会确定预防HDP的治疗靶点在治疗中有着巨大的希望。 预防心血管疾病在以后的生活。假设母亲有儿童性虐待史， 通过压力诱导的自主神经系统激活增加HDP的风险。常规产前 经验，包括产前护理预约，怀孕症状和胎动，可能是一个 对于有儿童性虐待历史的女性来说，这是一个重要的压力来源，因为这些经历可以作为 令人不安的性虐待记录因此，对身体感觉的感知（即，内感受）， 可能会引发自主应激反应，并增加遭受儿童性虐待的女性患HDP的风险 历史相反，与压力缓冲模型一致，支持性的社会环境可能会中断 内感受知觉和减少自主激活的妇女与儿童性虐待的历史。的 这项研究的目的是描述胎儿对胎儿期激素的内感受性和自主神经反应。 在有和没有CSA病史的女性中，将经验作为HDP的途径，并检查调节 社会背景的作用。我们将使用一种新的方法，通过整合EMA，动态生物特征 可穿戴技术和电子激活记录器（ESTA）方法，以严格评估日常 内感受性和自主神经反应的产前经验在整个妊娠。这一领域的成果 研究预计将对该领域产生重要的积极影响，因为可能会使用新知识 选择有意义的干预目标，以调节血压和HDP的发展， 预防心血管疾病在以后的生活。