Maternal and Infant Environmental Health Riskscape (MIEHR) Research Center

摘要 气候变化代表着一场史无前例的全球公共卫生危机，威胁还在不断增加， 特别是对于居住在沿海地区的人。母亲和儿童的健康风险尤其令人担忧。 随着越来越多的证据表明气温升高对孕产妇和儿童健康的影响。而相对较少的 调查探索了温度在黑人、棕色和土著母亲中的不同影响， 种族/族裔在围产期健康方面存在差异的证据是压倒性的和令人不安的，由来已久。 此外，少数族裔和低收入家庭由于同时接触这两种化学物质而经历“双重危险”。 以及多种环境中的非化学应激源。为了解决这些不平等，母婴 环境健康风险(MIEHR)研究中心，NIMHD/NIEHS/NICHD P50中心 建立了环境健康差异研究卓越项目，以阐明 环境风险景观的生物、物理、社会和建筑环境 黑人和白人孕妇及其婴儿的健康差异。MIEHR中心有两个 协同研究项目：项目1：环境风险、灾害和产科结果 一项流行病学研究，以确定暴露于混合化学品和其他化学物质之间的特定种族关联 基于地点的压力源与早产和项目2：母婴差异意识分类器 一项生物信息学研究，旨在开发和验证黑人和黑人早产的差异感知分类器 白人女性。为了支持这两个项目，我们正在招募在产科分娩的妇女。 得克萨斯医疗中心(TMC)是世界上最大的医疗中心。TMC是在更大的 休斯顿，那里的人口在种族/民族特征以及经济状况方面都非常多样化 财富和贫穷的二元性。此外，该地区经历了极端炎热和潮湿的夏季，其 靠近墨西哥湾海岸，容易发生飓风和洪水。通过利用MIEHR中心基础设施 并在我们先前工作的基础上，应用分布式滞后非线性模型(DLNLM)对曝光进行建模 有非线性和滞后的影响，我们建议评估气温上升和出生之间的联系 体重，这是一种围产期结局，会增加婴儿一生中的健康风险。具体目标 目的是：1)扩展MIEHR环境风险情景并汇编温度测量的时间序列 以及孕期的其他气象变量；2)应用DLNLMS调查 暴露于温度和出生体重的关键窗口；以及3)检查产妇的年龄、种族和 基于地点的压力源改变了体温升高和出生体重之间的联系。结果将为 将气候灾害作为当前MIEHR环境风险状况的一个关键因素进行的基础工作 中心研究项目，并在一项新的分析中，确定暴露在高温下的敏感窗口 关于出生体重，这将为未来保护孕妇免受高温暴露的努力提供参考。

ABSTRACT Climate change represents an unprecedented public health crisis world-wide with threats that are ever growing, particularly for persons living in coastal locations. Health risks to mothers and children are a particular concern with growing evidence of impacts of elevated temperatures on maternal and child health. Whereas relatively few investigations have explored differential impacts of temperature among Black, Brown, and Indigenous mothers, the evidence for racial/ethnic disparities in perinatal health is overwhelming and disturbingly long-standing. Further, minority and low-income families experience a “double jeopardy” because of exposures to both chemical and non-chemical stressors in multiple environments. To address these inequities, the Maternal and Infant Environmental Health Riskscape (MIEHR) Research Center, an NIMHD/NIEHS/NICHD P50 Center of Excellence on Environmental Health Disparities Research was established to elucidate contributions of the biological, physical, social, and built environments of the environmental riskscape to environmental health disparities in Black and White pregnant women and their infants. The MIEHR Center has two synergistic research projects: Project 1: The Environmental Riskscape, Disasters and Obstetric Outcomes, an epidemiological study to identify race-specific associations between exposures to a mixture of chemicals and place-based stressors and preterm birth and Project 2: Disparities Aware Classifiers for Maternal and Infant Health, a bioinformatics study to develop and validate disparity aware classifiers for preterm birth for Black and White women. In support of both projects, we are recruiting women who present for labor and delivery at obstetric hospitals in the Texas Medical Center (TMC), the largest medical center in the world. The TMC is in greater Houston, which has an immensely diverse population in terms of racial/ethnic profiles as well as an economic duality of wealth and poverty. Further, the area experiences extremely hot and humid summers and, with its proximity to the Gulf Coast, is prone to hurricanes and flooding. By leveraging the MIEHR Center infrastructure and building on our prior work applying distributed lag non-linear models (DLNLMs) for modeling exposures that have non-linear and lagged effects, we propose to evaluate associations between rising temperatures and birth weight, a perinatal outcome that increases health risks of infants throughout their life course. The Specific Aims are to: 1) Expand the MIEHR environmental riskscape and compile time series of measurements of temperature and other meteorological variables during pregnancy for study participants; 2) Apply DLNLMs to investigate critical windows of exposure to temperature and birth weight; and 3) Examine whether maternal age, race, and place-based stressors modify associations between elevated temperature and birthweight. Results will lay the groundwork for including climate hazards as a critical element of the environmental riskscape in current MIEHR Center research projects and, in a new analysis, identify susceptible windows of exposure to high temperatures on birthweight that will inform efforts to protect pregnant women from heat exposure in the future.