Stress and Health in American Indian Pregnancies

项目摘要/摘要 心血管疾病是美洲印第安人死亡的主要原因， 这一人群中与心血管相关的过早死亡率正在恶化。在2000至2015年间， 25-49岁美国印第安人的心血管疾病死亡率增加了 2.1%，但在美国其他种族/民族的同龄个人中下降或持平。 美国心脏协会最近呼吁对慢性心脏病的后果进行代际检查 儿童时期的逆境和创伤等压力对婴幼儿心血管危险因素的影响。 美国印第安人通过暴力、被迫搬迁和 被迫进行文化适应。此外，美国印第安人暴露在更高水平的有害物质中 童年经历(A)比美国其他种族/民族更多。婴儿的成长是一种 成年期心血管疾病的公认危险因素，但母亲之间的关系不利 未对美国印第安人的童年经历和婴儿成长进行研究。调查 慢性应激对母体下丘脑-垂体-肾上腺轴功能及母产的影响 结果很重要，因为这些机制可能存在于慢性应激和婴儿之间的途径上 成长。美国印第安人怀孕的压力与健康(SHIP)研究与 土著创伤和恢复能力研究中心与美国印第安人社区在#年合作 与文化相关的研究。Shaip研究将从3个部落招募375名怀孕的美国印第安人妇女 北达科他州的社区，在怀孕期间1次收集详细的生物、医学和社会数据，地址为 分娩、产后6个月和产后12个月。在目标1中，我们将评估两者之间的关联 孕期母体ACEs和母发皮质醇浓度。在目标2中，我们将检验假设 母体毛发皮质醇浓度在母体ACE与母体和 产科结局。最后，在目标3中，我们将考察母体之间关系的多个中介因素 ACES和婴儿成长。这项拟议的研究项目将使我能够第一次研究 母体王牌和婴儿成长之间的路径。潜在的可改变的媒介，如母乳喂养和 产妇健康可能成为针对北方美国印第安人的文化干预措施的依据 达科他州。实现这个项目的具体目标将使我成为一名领先的学者 母体ACEs和婴儿心脏代谢危险因素的代际传递。

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.