Ambient Air Pollution, Weather, and Placental Abruption (APWA)

环境空气污染、天气和胎盘早剥 (APWA)

基本信息

批准号：
10276251
负责人：
Cande V. Ananth
金额：
$ 68.04万
依托单位：
RBHS-ROBERT WOOD JOHNSON MEDICAL SCHOOL
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-10 至 2026-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10276251
关键词：
Abruptio Placentae Acute Address Affect Air Pollutants Air Pollution Air Pressure Ammonium Area Big Data Biological Birth Blood flow Caliber Calibration California Carbon Censuses Chronic Conceptions Crossover Design Data Data Science Databases Discipline of obstetrics Etiology Event Exposure to Fetal Growth Fetal Growth Retardation Fetal Heart Rate First Pregnancy Trimester Florida Functional disorder Future Gestational Diabetes Goals Health Heat Waves Hemorrhage High temperature of physical object Hospitals Humidity Individual Inflammatory Inhalation Ischemia Link Live Birth Location Massachusetts Measurement Mediating Mediation Michigan Mothers National Institute of Environmental Health Sciences Nature Neighborhoods Newborn Infant Nitrates Nitrogen Dioxide Non-linear Models Outcome Ozone Particulate Matter Partner in relationship Pathway interactions Physiological Placenta Placenta Diseases Pre-Eclampsia Pregnancy Pregnant Women Premature Birth Premature Rupture Fetal Membranes Process Public Health Research Residential Mobility Resolution Risk Risk Factors Role Severities Socioeconomic Status South Carolina Sulfate Temperature Time United States National Institutes of Health Ursidae Family Uterine Contraction Weather Woman ambient air pollution base cohort cold temperature design early pregnancy extreme heat fetus hypoxia fine particles implantation infant death obstetrical complication perinatal outcomes policy implication pollutant population based predictive modeling premature prepregnancy residence spatiotemporal stem stillbirth thrombotic

项目摘要

ABSTRACT Placental abruption results in hemorrhage, ischemia, and fetal hypoxia, placing a tremendous health burden on both the mother and the newborn. Efforts to understand the etiology of this devastating obstetrical complication have been disap- pointing. This project will delineate environmentally-associated pathways to abruption and determine the impact of pol- lutant triggers that are implicated in acute versus chronic placental abruption. Given that one-fourth of all abruption cases have an acute etiology and 15% of abruptions may recur in future pregnancies, the role of environmental triggers is a critically important, yet unexplored, opportunity to understand the pathophysiology of this enigmatic obstetrical compli- cation. The project will capitalize on high resolution exposure and health outcome data as it aims to develop a birth linkage database that will include hospital discharges linked to both stillbirths and live births-infant deaths to resident women in California, Florida, Massachusetts, Michigan, and South Carolina (estimated 16 million births, including 155,000 abruption cases) between 2000–2016. For each pregnancy we will assign average daily ambient exposure to fine particulate matter with an aerodynamic diameter ≤2.5 µm (PM2.5), its constituents (elemental carbon and organic carbon, sulfate, nitrate, and ammonium), as well as gaseous pollutants (nitrogen dioxide and ozone), using spatiotemporally resolved models that predict exposure for each residential location. We will also assign every residence with average daily temperature, humid- ity, dew point, heat waves, and atmospheric air pressure. The project will focus on disentangling the relative contributions of ambient air pollution and weather-related conditions on acute abruption through a bi-directional, time-stratified case- crossover design, and those of abruptions with chronic underpinnings using a cohort design. We will apply distributed lag linear and non-linear models to identify critical windows of exposure, Bayesian Kernel Machine Regression to characterize associations based on multi-pollutant exposures, and causal interaction-mediation decomposition analyses through ischemic placental disease (preeclampsia, fetal growth disturbances). We will consider individual– and neighborhood–level con- founders derived from residential census tracts. All associations will be corrected for simultaneous exposure and outcome misclassification, as well as for exposure measurement error owing to maternal residential mobility through a regression calibration approach. The ubiquitous nature of air pollution and weather exposures and their potential impact on adverse perinatal outcomes, as well as the preliminary data supporting the associations, presents unprecedented opportunities to address implications of the adverse impact of air pollution and weather-related exposures on placental abruption and related obstetrical complications. This project aligns with 2 major critical areas of research–Co-exposures, and Data Sci- ence and Big Data–outlined in the 2018-2023 strategic goals of NIH-National Institute of Environmental Health Sciences.

抽象的胎盘的破裂导致出血，缺血和胎儿缺氧，给两者都带来了巨大的健康负担母亲和新生儿都可以理解这种毁灭性的产科汇编的病因指向这个项目，以划定与环境相关的途径，并确定与急性与慢性胎盘的突然相关的Lutant触发器。具有急性病因，在未来怀孕中可能会复发15％的破裂，环境触发器的作用是至关重要但尚未探索的机会，可以理解这种神秘的观察汇编的病理生理学阳离子。数据库，其中包括与死产和现场出生的死亡有关的医院出院加利福尼亚，佛罗里达州，马萨诸塞州，密歇根州和南卡罗来纳州（估计有1600万个出生，包括155,000 案例）20016年。对于每次怀孕具有空气动力学直径≤2.5µm（PM2.5），它的偶性（元素碳和有机碳，硫酸盐，硝酸盐，硝酸盐，硝酸盐，和铵）以及气态污染物（二氧化氮和臭氧），使用时空分辨的模型。预测每个住宅位置的曝光率。 ITY，露点，热浪和大气气压将集中在相对贡献上环境空气污染和与天气相关的条件在急性破裂时通过双向分解的病例跨界设计，以及使用分布式滞后的时间基础的突发性设计。线性和非线性模型以识别曝光的关键窗口，贝叶斯内核机回归以表征基于多污染物暴露和因果相互作用分解分解分解的关联使血管血症胎盘疾病（先兆子痫，胎儿生长干扰）。衍生自死亡人口普查的创始人将对同时接触和结果进行纠正由于产妇的住宅流动性通过性通过回归校准方法。围产期结果，作为支持协会的预预制作数据，提出了未经证实的机会解决空气污染和与天气相关的暴露对胎盘的破裂和相关的产科并发症。 ENCE和大数据 - 在NIH-NATIUTTE环境健康科学的2018 - 2023年战略目标中概述。