Coronary Heart Disease in Black Women: The Role of Adverse Pregnancy Outcomes

项目摘要 拟议的五年职业发展期将用于研究和培训活动， 博士萨曼莎帕克的技能和经验，成为一个独立的调查员。帕克医生 长期职业目标是将生命过程流行病学的理论和分析工具应用于 不良妊娠结局和母体心血管疾病风险。建立在强大的背景下， 生殖流行病学和流行病学方法，帕克博士提出了内容领域的培训， 心血管流行病学和生命过程流行病学统计方法的应用技能，包括 调解分析。她还包括关于健康的社会决定因素的培训， 与不良妊娠结果有关的个人和社区社会决定因素， 心血管疾病培训计划包括正式的课程、专题讨论会和讲习班， 经验，并建立一个指导小组，代表每个培训领域的专门知识。的 研究的目的是调查不良妊娠结局与母体妊娠风险之间的关系。 黑人妇女健康研究中的冠心病（CHD），这是美国黑人妇女最大的队列研究。 美国的关于这一主题的证据越来越多地存在于以白色为主的人群中， 但在黑人人群中缺乏证据，尽管冠心病的种族差异持续存在， 发病率和死亡率。这些目标还将解决冠心病临床风险因素的介导问题，包括慢性 高血压和糖尿病，并通过个人水平和社区水平生命过程测量进行修正 健康的社会决定因素。

PROJECT SUMMARY This proposed five-year career development period will be used for research and training activities that will give Dr. Samantha Parker the skills and experience necessary to become an independent investigator. Dr. Parker’s long-term career goal is to apply the theory and analytical tools of life course epidemiology to the study of adverse pregnancy outcomes and risk of maternal cardiovascular disease. Building on a strong background in reproductive epidemiology and epidemiologic methods, Dr. Parker has proposed content area training in cardiovascular epidemiology and applied skills of statistical methods for life course epidemiology, including mediation analysis. She has also included training regarding social determinants of health to learn about individual-level and neighborhood-level social determinants as they relate to adverse pregnancy outcomes and cardiovascular disease. The training plan involves formal coursework, symposia and workshops, and didactic experiences and the establishment of a mentoring panel representing expertise in each training domain. The research aims are to investigate the association between adverse pregnancy outcomes and maternal risk of coronary heart disease (CHD) in the Black Women’s Health Study, the largest cohort study of black women in the United States. An accumulating body of evidence on this topic exists in predominantly white populations, but there is a dearth of evidence among black populations, despite persistent racial disparities in CHD morbidity and mortality. The aims will also address mediation by clinical risk factors for CHD, including chronic hypertension and diabetes, and modification by life course measures of individual-level and neighborhood-level social determinants of health.