Project 2: Heat Waves during Pregnancy, Neurodevelopment, and Resiliency

项目摘要-组成部分：研究项目2 随着热浪和极端天气事件的增加，干旱土地上的人口和城市的热促进 风景可能会增加患上与高温相关的疾病的风险。尽管最近的证据表明， 孕期热浪与早产和分娩结局的关系 对儿童神经发育的影响仍未被研究。动物和细胞模型表明，温度 对调节神经功能的系统有深远的影响。横断面研究表明高温 压力会导致昏昏欲睡和疲惫不堪，并可能加重注意力缺陷多动障碍的症状 (ADHD)。前瞻性地，怀孕小鼠的模拟热浪会导致神经损伤和氧化 压力，改变胎盘发育，缩小头部大小。在人体研究中，在我们的试点数据中 在亚利桑那州，70万新生儿，怀孕期间的热浪与较低的阿普加评分有关，这是一种 出生时的健康指标，与后来的神经功能(包括ADHD)有关。然而，尽管 这一证据、对热浪和后来的神经发育的研究仍然没有出现在文献中。 因此，与西南应对气候变化和健康中心的使命相一致 (SCOCH)，我们建议利用亚利桑那大学独特的资源，利用三十年 现有的、基于人口的医疗补助和出生证明数据，以调查温度与 孕期暴露对婴儿健康和儿童神经发育(阿普加评分和ADHD)的影响 在亚利桑那州生活了30年(1992-2022)。我们将采用研究到行动的框架，并与 我们的社区参与核心，以传达关于热量、神经发育和婴儿健康的研究结果，以 社区团体、公共卫生机构和市政当局。由于气候变化的紧迫性 在应对方面，我们还认识到通过以下方式促进气候变化适应能力的关键重要性 评估建成环境和政策是否可能改变这些气候-健康关系。CO-I博士 拉德·基思将市政政策整合到一个人口普查区域级别的耐热记分卡中，称为 针对热力的Resiliency Scorecard(PIRS)计划集成，在部分城市公开提供。 其他几个气候适应因素(例如，运输路线、冷却中心、树冠、住房类型)是 热量和健康的潜在重要修饰物，尽管这些数据存在于不同的来源，不同的 时间表和不同的决议。与集成数据可视化核心(IDVC)一起，我们将 整合、链接到健康结果，并发布这些数据，这些数据将与100万英镑一起跨越数十年 观察。这将促进数据的广泛使用，并加快其他调查人员对 气候变化缓解和建筑环境如何促进气候适应能力。这项提议将 此外，还可以作为SCOCH支持的分析的展示窗口，这些分析将受保护的健康数据与 将通过综合数据可视化核心建立的在线仪表板获得的公共数据。

PROJECT ABSTRACT – Component: Research Project 2 As heatwaves and extreme weather events increase, populations in arid lands and urban heat-promoting landscapes may be at increased risk for heat-related illnesses. Although recent evidence suggests a strong association between heatwaves during pregnancy with preterm births and birth outcomes, the downstream effects on childhood neurodevelopment remain unexplored. Animal and cellular models show that temperature has profound effects on systems that regulate neurological functioning. Cross-sectional studies suggest heat stress induces lethargy and exhaustion, and may worsen symptoms of attention deficit hyperactivity disorder (ADHD). Prospectively, simulated heatwaves in pregnant mice induce neurological damage and oxidative stress, alter placental development, and diminish head size. In human studies, and in our pilot data of >700,000 births in Arizona, heatwaves during pregnancy are associated with lower Apgar score, which is a metric of health at birth and associated with later neurological functioning (including ADHD). However, despite this evidence, investigations of heatwaves and later neurodevelopment remain absent from the literature. Thus, in alignment with the mission of the Southwest Center on Resilience for Climate Change and Health (SCORCH), we propose to leverage the unique resources at the University of Arizona and use three decades of extant, population-based Medicaid and birth certificates data to investigate associations of temperature exposures during pregnancy on infant health and childhood neurodevelopment (Apgar score and ADHD) over three decades (1992-2022) in the state of Arizona. We will adopt a research-to-action framework and work with our Community Engagement Core to communicate findings on heat, neurodevelopment, and infant health, to community groups, public health agencies, and municipalities. Due to the urgent nature of climate change response, we additionally recognize the critical importance of promoting climate change resiliency by evaluating whether the built environment and policy may modify these climate-health relationships. Co-I Dr. Ladd Keith has consolidated municipal policy into a heat resiliency scorecard at the census-tract level, called the Plan Integration for Resiliency Scorecard (PIRS) for Heat, which is publicly available in select cities. Several other climate resiliency factors (e.g., transit routes, cooling centers, tree canopy, housing type) are potentially important modifiers of heat and health, although these data exist in disparate sources, at different timelines, and disparate resolutions. Together with the Integrated Data Visualization Core (IDVC), we will consolidate, link to health outcomes, and publish this data that will span multiple decades with >1million observations. This will facilitate broad data usage and accelerate critical research by other investigators on how climate change mitigation and the built environment promote climate resiliency. This proposal will additionally serve as a showcase for SCORCH-supported analyses that integrate protected health data with public data that will be available via online dashboards built by the Integrated Data Visualization Core.