Maternal and Developmental Risks from Environmental and Social Stressors (MADRES)

环境和社会压力因素带来的孕产妇和发育风险 (MADRES)

• 批准号: 10586082
• 负责人: Theresa M Bastain
• 金额: $ 151.39万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10586082
• 关键词: Acculturation; Address; Affect; African American population; Air Pollution; Attention; Awareness; Behavior; California; Cardiovascular Diseases; Cardiovascular system; Characteristics; Chemicals; Childbirth; Clinical; Country; Data; Development; Elderly; Environmental Exposure; Environmental Hazards; Environmental Health; Environmental Impact; Environmental Risk Factor; Exposure disparity; Exposure to; Functional disorder; Health; Health Disparities Research; Hispanic; Hispanic Americans; Hypertension; Immigrant; Individual; Inequity; Inflammatory; Intervention; Knowledge; Language; Lead; Low income; Maternal Health; Mediating; Mental Depression; Mental Health; Mental Health Services; Mentorship; Minority; Morbidity - disease rate; Neighborhoods; Neurosecretory Systems; Not Hispanic or Latino; Outcome; Pathway interactions; Pattern; Persons; Policies; Population; Positioning Attribute; Postpartum Period; Pre-Eclampsia; Predisposition; Pregnancy; Pregnancy Complications; Prevalence; Prevention; Prevention strategy; Psychiatry; Psychosocial Stress; Public Health; Recommendation; Research; Research Personnel; Research Project Grants; Residential Mobility; Risk; Risk Factors; Science; Scientist; Stress; Woman; allostatic load; built environment; burden of illness; cardiometabolism; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; cohort; community building; community engagement; disorder prevention; disparity elimination; environmental health disparity; environmental stressor; ethnic disparity; experience; health care service; health disparity; health disparity populations; innovation; interdisciplinary approach; knowledge base; maternal depression; maternal morbidity; men; mortality; multidisciplinary; next generation; postpartum health; preference; prenatal; prenatal environmental exposure; prenatal exposure; prevention practice; programs; racial disparity; social; social stressor; stressor

PROJECT SUMMARY/ABSTRACT—OVERALL CENTER Eliminating disparities in maternal health outcomes is a national priority, especially given the numerous adverse health sequelae. Moreover, pregnancy may be an underappreciated period of susceptibility to environmental exposures and impacts on later maternal health outcomes. Given the lack of data on the relationships between prenatal exposures and stressors with postpartum maternal health, we will focus the renewal cycle for the Maternal And Developmental Risks from Environmental and Social Stressors (MADRES) Center on two maternal health outcomes of utmost concern: maternal depression and cardiovascular health in the years after childbirth. Depression is the leading cause of mental health-related morbidity worldwide, affecting approximately 300 million people and is nearly twice as prevalent among women than men. US Hispanic women, have unique risk factors relative to non-Hispanic women including overcoming stress associated with acculturation and under-utilization of mental health care services. In parallel, cardiovascular disease (CVD) remains the number one cause of mortality and the prevalence of CVD has continued to climb among US women despite greater awareness and prevention efforts. Cardiovascular conditions that arise during the prenatal period, such as preeclampsia and hypertension, may have persistent effects into the postpartum period and predict elevated risk of later life CVD. Despite this growing evidence, there is little to no research on whether exposure to environmental and social stressors during this vulnerable period may promote cardiovascular dysfunction or maternal depression years later. This is particularly important in California, where the burden of exposures is not evenly distributed, with Hispanic and African-American populations carrying the greatest burden of environmental exposures. Understanding risk factors for maternal depression and CVD among health disparity populations in the first 4 years postpartum is necessary to reduce the disproportionate burden of disease borne by these individuals. The MADRES Center will examine whether prenatal environmental exposures and social stressors lead to higher depression and/or cardiovascular risk factors postpartum and whether patterns in exposure disparities from the built environment and physical, chemical or social stressors at the residential and neighborhood level relate to individual-level characteristics including allostatic load. The MADRES Center combines three innovative research projects, a strong Community Engagement and Dissemination Core, a comprehensive Investigator Development Core, and a synergizing Administrative Core. The MADRES Center brings together clinical, environmental, social and public health scientists and community engagement professionals to create a world-class research program in environmental health disparities. Our collaborative, multi-disciplinary approach will address key gaps needed for timely and effective disease prevention strategies and recommendations for approaches to reduce maternal morbidity in the years following childbirth.

项目概要/摘要——整体中心 消除孕产妇健康结果的差异是国家的优先事项，特别是考虑到许多不利因素 健康后遗症。此外，怀孕期可能是一个容易受到环境影响的时期，但这一时期却未被充分认识到。 暴露及其对以后孕产妇健康结果的影响。由于缺乏关于之间关系的数据 产前暴露和压力源与产后孕产妇健康，我们将重点关注更新周期 环境和社会压力因素造成的孕产妇和发育风险 (MADRES) 中心针对两名孕产妇 最受关注的健康结果：产后几年的产妇抑郁症和心血管健康。 抑郁症是全球心理健康相关发病率的主要原因，影响约 3 亿人 人中的患病率几乎是男性的两倍。美国西班牙裔女性有独特的危险因素 相对于非西班牙裔女性，包括克服与文化适应和利用不足相关的压力 的精神卫生保健服务。与此同时，心血管疾病（CVD）仍然是导致心血管疾病的第一大原因。 尽管美国女性的意识和意识有所提高，但心血管疾病的死亡率和患病率仍在持续攀升 预防工作。产前期间出现的心血管疾病，例如先兆子痫和 高血压可能会对产后期产生持续影响，并预测晚年 CVD 风险升高。 尽管有越来越多的证据，但几乎没有研究表明暴露于环境和社会环境是否会影响健康。 这个脆弱时期的压力源可能会促进心血管功能障碍或母亲抑郁症 之后。这在加利福尼亚州尤为重要，因为那里的暴露负担分布不均匀， 西班牙裔和非裔美国人承受着最大的环境暴露负担。 了解健康差异人群中孕产妇抑郁症和心血管疾病的危险因素 产后前 4 年对于减少这些人所承受的不成比例的疾病负担是必要的 个人。 MADRES 中心将检查产前环境暴露和社会压力源是否 导致更高的抑郁症和/或产后心血管危险因素以及暴露模式是否 住宅和住宅区的建筑环境以及物理、化学或社会压力源的差异 邻里水平与个人水平特征相关，包括非稳态负荷。马德雷斯中心 结合了三个创新研究项目、强大的社区参与和传播核心、 全面的研究者发展核心和协同管理核心。马德雷斯中心 汇集临床、环境、社会和公共卫生科学家以及社区参与 专业人士创建世界一流的环境健康差异研究项目。我们的协作， 多学科方法将解决及时有效的疾病预防战略所需的关键差距 以及关于降低产后几年孕产妇发病率的建议。