Maternal exposure to childhood abuse and disparities in offspring neurodevelopment:Effects of COVID-19 pandemic-related stress

项目总结 遭受儿童期虐待的妇女的孩子患上一系列神经发育障碍的风险增加 身体缺陷，患焦虑、抑郁、自闭症和注意力缺陷障碍(ADHD)的风险增加。这个 父母补助试图确定怀孕期间可能导致这种风险增加的生物调节失调。 炎症和荷尔蒙失调损害后代神经发育，并存在于 经历过童年虐待，但尚不清楚这些系统中的失调是否会在 遭受虐待的妇女怀孕，这是对后代大脑产生影响的关键时期。家长助学金 在怀孕期间收集生物样本来测量炎症和激素失调， 未来的女性队列。有儿童期虐待史的女性在 怀孕，父母拨款的目标2假设这些应激源可能部分地解释了怀孕 生物性失调。在这份行政副刊中，我们建议扩大研究，以捕捉关键 以及新冠肺炎疫情的时间敏感数据。我们假设与大流行相关的不良事件 而压力将在遭受虐待儿童的女性中更为常见，并将增加生物风险 怀孕期间对后代发育有害的调节失调。妊娠期不良事件 对它们的心理反应与妊娠并发症、早产、低出生有关 体重和后代神经发育缺陷。易受伤害的人群，包括暴露于 儿童期虐待，可能会经历更多此类不良事件，并受到更多负面影响 他们。预测模型表明，在缺乏疫苗的情况下，SARS-CoV-2很可能会继续 在可预见的未来传播，突出了对长期健康的强有力研究的迫切需要 大流行对孕妇及其后代的影响。通过家长奖项注册的参与者包括 护士健康研究的成员3名，而且大多数都是临床活跃的，因此本研究具有优势 直接接触大量职业接触SARS-CoV-2高风险人群。同时 随着时间的推移，他们很容易受到医疗行业裁员和失业的影响，这使得这一群体成为研究 大流行相关应激源对妊娠和分娩结果的影响。该补编将收集以下数据： 孕前和孕期新冠肺炎相关不良事件和新冠肺炎相关应激， 包括对感染的恐惧、经济压力、大流行相关的抑郁、育儿压力和疾病，以及 亲人离世。这项研究将解决NICHD的核心使命，即确保“所有儿童都有 有机会充分发挥其健康和富有成效的生活的潜力，“通过确定因素”，从之前开始 受孕，[可以]影响整个生命过程和世代的发展。

PROJECT SUMMARY Children of women exposed to childhood abuse exhibit increased risk for a wide array of neurodevelopmental deficits and are at elevated risk of anxiety, depression, autism, and attention deficit disorder (ADHD). The parent grant seeks to identify biological dysregulation during pregnancy that may cause this increased risk. Inflammation and hormonal dysregulation harms offspring neurodevelopment and is present in adults who have experienced childhood abuse, yet it is unknown whether dysregulation in these systems continues during the pregnancies of women exposed to abuse, the critical time for effects on offspring brains. The parent grant collects biological samples during pregnancy to measure inflammation and hormonal dysregulation in a large, prospective cohort of women. Women with histories of childhood abuse experience more stressors during pregnancy, and Aim 2 of the parent grant posits that these stressors may partially account for pregnancy biological dysregulation. In this administrative supplement, we propose to augment the study to capture key and time sensitive data on the COVID-19 pandemic. We hypothesize that pandemic-related adverse events and stress will be more common in women exposed to child abuse and will increase risk for biological dysregulation during pregnancy that is harmful to offspring development. Adverse events during pregnancy and psychological reactions to them have been linked to pregnancy complications, prematurity, low birth weight, and offspring neurodevelopmental deficits. Vulnerable populations, including women exposed to childhood abuse, are likely to experience more of these adverse events and be more negatively impacted by them. Forecasting models suggest that in the absence of a vaccine, SARS-CoV-2 is likely to continue circulating for the foreseeable future, highlighting the urgent need for robust research on the long-term health effects of the pandemic on pregnant women and their offspring. Participants enrolled via the parent award are members of the Nurses' Health Study 3, and most are clinically active, thus this study has the advantage of having direct access to a large population with high risk of occupational exposure to SARS-CoV-2. At the same time, they are vulnerable to healthcare sector downsizing and job loss, making the cohort ideal for studying the effects of pandemic-related stressors on pregnancy and birth outcomes. The supplement will collect data on COVID-19-related adverse events and COVID-19-related stress at both pre-pregnancy and pregnancy, including fear of infection, financial stress, pandemic-related depression, parenting stress, and illness and death of loved ones. This research will address the NICHD's core mission to ensure that “all children have the chance to achieve their full potential for healthy and productive lives” by identifying factors, “starting before conception, [that] can influence development across the life course and across generations.”