2/5 The Cumulative Risk of Substance Exposure and Early Life Adversity on Child Health Development and Outcomes

项目摘要/摘要 在美国，产妇死亡率和严重产妇发病率比几乎 在所有欧洲国家，这是妇女健康差距最明显的例子之一。一 与妊娠期多种孕产妇并发症相关的可改变的危险因素是睡眠健康。 围产期睡眠健康差被发现与几种情况有关 已知会增加孕产妇健康并发症和死亡率的风险，如妊娠 糖尿病、妊娠高血压、先兆子痫和抑郁症。此外，更大的风险 报告睡眠不佳的情况在少数族裔中发生。尽管如此，睡眠健康 孕妇和医疗保健提供者通常认为变化是“正常的”，而且有一种 对怀孕期间睡眠健康的正常/异常变化缺乏了解。 这种知识差距的部分原因是缺乏经济实惠、易于使用和可靠的睡眠 可在家中使用的监控设备。目前的提案将调查以下项目的可行性 使用可获取2导联脑电和心电的可穿戴设备监测怀孕期间和 特别是在产妇结局不佳的高危美国印第安人群体中。我们的假设 是：1)我们将在送货上门和收集设备方面有积极的体验 研究所有种族群体的人口和2)我们将收集至少75%的可用数据 夜间记录，这将允许我们使用 经过验证的AI平台。 我们的目标是确定可穿戴解决方案是否可以提供睡眠实验室评估的可行替代方案 以及更具侵入性的家庭监控解决方案。鉴于目前的情况，这项调查特别相关 大流行，这影响了孕妇安排就诊的能力和动机 以医院为基础的研究，使远程医疗解决方案成为更好的解决方案。 总而言之，睡眠已被证明是一个可修改的风险因素，而且实用工具的可用性也是如此 评估家庭环境中的睡眠健康将为改善产妇健康提供机会， 正如改善倡议目标中概述的那样，支持关于如何减少可预防疾病的研究 在美国，降低孕产妇死亡率，降低严重的孕产妇发病率，促进卫生公平。

Project Summary/Abstract In the United States, rates of maternal mortality and severe maternal morbidities are higher than almost all European countries and provide one of the starkest examples of women's health disparities. One modifiable risk factor associated with multiple maternal complications during pregnancy is sleep health. Poor sleep health in the perinatal period has been found to be associated with several conditions known to increase the risk for maternal health complications and mortality, such as gestational diabetes, pregnancy-induced hypertension, preeclampsia, and depression. Additionally, greater risk incidence of poor sleep reports occurs among racial/ethnic minorities. Nonetheless, sleep health changes are often regarded by pregnant women and healthcare providers as “normal” and there is a lack of understanding on what constitutes normal/abnormal variations in sleep health during pregnancy. This knowledge gap in part, derives from the lack of cost-effective, easy-to use and reliable sleep monitoring devices that can be used in the home. The current proposal will investigate the feasibility of using wearable devices that acquires 2-lead EEG and ECG to monitor sleep during pregnancy and specifically in an American Indian population at high risk for poor maternal outcome. Our hypotheses are that: 1) we will have a positive experience in home delivery and collection of devices in the general study population across all racial ethic groups and 2) we will collect a minimum of 75% usable data for the overnight recordings, which will allow us to acquire and derive sleep health metrics using a validated AI platform. Our goal is to establish if wearable solutions would provide viable alternatives to sleep lab assessments and more invasive in-home monitor solutions. This investigation is particularly relevant given the current pandemic, which has affected the ability and motivation for pregnant women to schedule visits for hospital-based studies, making telehealth solutions a preferable solution. In conclusion, sleep has been shown to be a modifiable risk factor and the availability of practical tools to assess sleep health in the home environment will afford the opportunity to improve maternal health, as outlined in the IMPROVE initiative goals, to support research on how to mitigate preventable maternal mortality, decrease severe maternal morbidity, and promote health equity in the U.S.