Stress and Health in American Indian Pregnancies

美洲印第安人怀孕期间的压力与健康

• 批准号: 10091064
• 负责人: Andrew David Williams
• 金额: $ 28.96万
• 依托单位: UNIVERSITY OF NORTH DAKOTA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-01 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10091064
• 关键词: Acculturation; Address; Adult; Age; American Heart Association; American Indians; Biological; Birth; Breast Feeding; Cardiovascular Diseases; Cardiovascular system; Centers of Research Excellence; Child; Chronic stress; Communities; Data; Development; Dose; Enrollment; Epidemiology; Ethnic group; Event; Exposure to; Future; Gestational Diabetes; Goals; Growth; Hair; Health; Hydrocortisone; Indigenous; Individual; Infant; Intervention; Investigation; Life; Linear Regressions; Link; Logistic Regressions; Longevity; Low Birth Weight Infant; Maternal Health; Maternal and Child Health; Measurement; Measures; Mediating; Mediator of activation protein; Medical; Medical Records; Mental Health; Mentors; Methods; Morbidity - disease rate; Mothers; North Dakota; Pathway interactions; Population; Postpartum Period; Pregnancy; Premature Birth; Premature Mortality; Prospective cohort study; Psychosocial Factor; Reporting; Research; Research Project Grants; Risk; Risk Factors; Role; Sampling; Small for Gestational Age Infant; Stress; Substance abuse problem; Surveys; Testing; Time; Trauma; United States; Violence; Woman; adverse childhood events; aged; cardiometabolic risk; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; career; childhood adversity; cohort; feeding; follow-up; health disparity; hypothalamic-pituitary-adrenal axis; infant outcome; intergenerational; maternal outcome; mortality; northern plains; novel; obstetric outcomes; pediatric trauma; pregnancy disorder; pregnant; prenatal; racial and ethnic; resilience; response; social; transmission process; traumatic event; tribal community

Project Summary/Abstract Cardiovascular disease is the leading cause of mortality among American Indian populations, and cardiovascular-related premature mortality among this population is worsening. Between 2000 and 2015, cardiovascular disease mortality rates among American Indian individuals aged 25-49 years increased by up to 2.1%, yet declined or plateaued among similarly aged individuals in other racial/ethnic groups in the U.S. The American Heart Association recently called for intergenerational examinations of consequences of chronic stress, such as childhood adversity and trauma, on cardiovascular risk factors among infants and children. American Indian populations have been exposed to historic trauma through violence, forced relocation and forced acculturation. Additionally, American Indian populations are exposed to higher levels of Adverse Childhood Experiences (ACEs) than other racial/ethnic groups in the United States. Infant growth is a recognized risk factor for cardiovascular disease in adulthood, yet the relationship between maternal adverse childhood experiences and infant growth among American Indian populations is unexamined. Investigation of the effect of chronic stress on maternal hypothalamic-pituitary-adrenal axis function and maternal and obstetric outcomes is important, as these mechanisms may lie on the pathway between chronic stress and infant growth. The Stress and Health in American Indian Pregnancies (SHAIP) study aligns with the goals of the Indigenous Trauma and Resiliency Research Center by partnering with American Indian communities in culturally relevant research. The SHAIP study will enroll 375 pregnant American Indian women from 3 tribal communities in North Dakota, collecting detailed biologic, medical, and social data 1 time during pregnancy, at birth, at 6 months postpartum and at 12 months postpartum. In Aim 1, we will assess the association between maternal ACEs and maternal hair cortisol concentration during pregnancy. In Aim 2, we will test the hypothesis that maternal hair cortisol concentration mediates the association between maternal ACEs and maternal and obstetric outcomes. Lastly, in Aim 3, we will examine multiple mediators of the relationship between maternal ACEs and infant growth. This proposed research project will allow me to examine, for the first time, potential pathways between maternal ACEs and infant growth. Potentially modifiable mediators like breastfeeding and maternal health may inform culturally informed interventions targeting American Indian populations in North Dakota. Achieving the Specific Aims of this project will enable me to establish myself as a leading scholar in the intergenerational transmission of maternal ACEs and cardiometabolic risk factors among infants.

项目概要/摘要 心血管疾病是美洲印第安人死亡的主要原因， 该人群中与心血管相关的过早死亡率正在恶化。 2000年至2015年间， 25-49 岁美洲印第安人心血管疾病死亡率增加高达 2.1%，但在美国其他种族/族裔群体中年龄相近的个体中这一比例有所下降或趋于稳定。 美国心脏协会最近呼吁对慢性疾病的后果进行代际检查 压力（例如童年逆境和创伤）对婴儿和儿童心血管危险因素的影响。 美洲印第安人因暴力、强迫搬迁和 强迫文化适应。此外，美洲印第安人面临更高水平的不利因素 童年经历 (ACE) 高于美国其他种族/族裔群体。婴儿的成长是一个 公认的成年期心血管疾病的危险因素，但母体不良反应与 美洲印第安人的童年经历和婴儿成长尚未得到检验。调查 慢性应激对孕产妇下丘脑-垂体-肾上腺轴功能及孕产妇的影响 结果很重要，因为这些机制可能存在于慢性压力和婴儿之间的途径上。 生长。美洲印第安人怀孕期间的压力与健康 (SHAIP) 研究与该项目的目标一致 土著创伤和复原力研究中心与美洲印第安人社区合作 文化相关的研究。 SHAIP 研究将招募来自 3 个部落的 375 名怀孕的美国印第安妇女 北达科他州的社区，在怀孕期间收集详细的生物、医疗和社会数据 1 次，地址： 出生、产后 6 个月和产后 12 个月。在目标 1 中，我们将评估之间的关联 怀孕期间母亲 ACE 和母亲头发皮质醇浓度。在目标 2 中，我们将检验假设 母亲头发皮质醇浓度介导母亲 ACE 与母亲和母亲之间的关联 产科结果。最后，在目标 3 中，我们将研究母亲与母亲之间关系的多个中介因素。 ACE 和婴儿生长。这个拟议的研究项目将使我第一次检验潜在的 母亲 ACE 与婴儿生长之间的途径。潜在可改变的中介因素，如母乳喂养和 产妇健康可以为针对北部美洲印第安人人口的文化干预措施提供信息 达科他州。实现该项目的具体目标将使我能够成为该领域的领先学者 母亲 ACE 的代际传播和婴儿的心脏代谢危险因素。