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.

项目摘要/摘要 - 全中心 消除孕产妇健康成果中的分配是国家优先事项，特别是考虑到众多逆境 健康后遗症。此外，怀孕可能是对环境敏感的一个不足的时期 暴露和影响后来的遗嘱健康结果。考虑到缺乏有关关系的数据 产前暴露和应激源于产后健康，我们将重点申请更新周期 环境和社会压力源（MADRES）的孕产妇和发展风险集中在两个母亲 最引起最大关注的健康结果：分娩后的几年中的孕产妇抑郁症和心血管健康。 抑郁症是全球与心理健康相关的发病率的主要原因，影响了约3亿 人，在女性中几乎是男性的两倍。美国西班牙裔妇女，有独特的风险因素 相对于非西班牙裔妇女，包括与适应和利用不足有关的克服压力 精神保健服务。同时，心血管疾病（CVD）仍然是 死亡率和CVD的普遍性继续在美国妇女目的地中攀升，更高的认识和 预防努力。在产前期间出现的心血管疾病，例如先兆子痫和 高血压，可能对产后时期产生持续的影响，并预测以后CVD的风险升高。 尽管有越来越多的证据，但几乎没有关于暴露于环境和社会的研究 在这个脆弱时期的压力源可能会促进心血管功能障碍或造物抑郁症年 之后。这在加利福尼亚州尤其重要，那里的暴露燃烧均未均匀分布， 西班牙裔和非裔美国人人口遭受了最大的环境暴露燃烧。 了解健康差异人群中母亲抑郁和CVD的危险因素 产后的头四年是减少这些疾病的不成比例燃烧所必需的 个人。马德雷斯中心将检查产前环境暴露和社会压力源 导致产后抑郁症和/或心血管危险因素较高，以及暴露模式是否存在 与住宅的建筑环境以及物理，化学或社会压力源的差异 与个人级别特征有关的社区级别，包括同层负载。马德里斯中心 结合了三个创新的研究项目，一个强大的社区参与和传播核心， 全面的研究者开发核心和协同的行政核心。马德里斯中心 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分布研究计划。我们的合作 多学科方法将解决及时有效预防疾病策略所需的关键差距 以及在分娩后几年中降低产妇发病率的方法的建议。