Stress and Health in American Indian Pregnancies

美洲印第安人怀孕期间的压力与健康

• 批准号: 10360444
• 负责人: Andrew David Williams
• 金额: $ 27.41万
• 依托单位: UNIVERSITY OF NORTH DAKOTA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-01 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10360444
• 关键词: Acculturation; Address; Adult; Age; American Heart Association; American Indians; Biological; Birth; Breast Feeding; Cardiovascular Diseases; Cardiovascular system; Centers of Research Excellence; Child; Chronic stress; Communities; Data; Development; Dose; Enrollment; Epidemiology; Ethnic group; Event; Exposure to; Future; Gestational Diabetes; Goals; Growth; Hair; Health; Hydrocortisone; Hypertension; Indigenous; Individual; Infant; Intervention; Investigation; Life; Linear Regressions; Link; Logistic Regressions; Longevity; Low Birth Weight Infant; Maternal Health; Maternal and Child Health; Measurement; Measures; Mediating; Mediator of activation protein; Medical; Medical Records; Mental Health; Mentors; Methods; Morbidity - disease rate; Mothers; North Dakota; Pathway interactions; Population; Postpartum Period; Pregnancy; Premature Birth; Premature Mortality; Prospective cohort study; Psychosocial Factor; Reporting; Research; Research Project Grants; Risk; Risk Factors; Role; Sampling; Small for Gestational Age Infant; Stress; Substance abuse problem; Surveys; Testing; Time; Trauma; United States; Violence; Woman; adverse childhood events; aged; cardiometabolic risk; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; career; childhood adversity; cohort; feeding; follow-up; health disparity; hypothalamic-pituitary-adrenal axis; infant outcome; intergenerational; maternal outcome; mortality; northern plains; novel; obstetric outcomes; pediatric trauma; pregnancy disorder; pregnant; prenatal; racial and ethnic; resilience; response; social; transmission process; traumatic event; tribal community

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.

项目摘要/摘要 心血管疾病是美国印第安人人口死亡的主要原因， 该人群中与心血管相关的早亡率正在恶化。在2000年至2015年之间 25-49岁的美洲印第安人的心血管疾病死亡率增加到 在美国其他种族/族裔类似的个人中，有2.1％的人在美国其他种族/族裔中的年龄相似或降低了 美国心脏协会最近要求对慢性后果的代际检查 儿童和创伤等压力，例如婴儿和儿童的心血管危险因素。 美洲印第安人的人口通过暴力，强迫搬迁和 强迫适应。此外，美洲印第安人的人口暴露于更高水平的不利 与美国其他种族/族裔群体相比，童年经历（ACE）。婴儿的生长是 成年后心血管疾病的公认危险因素，但产妇不良之间的关系 美洲印第安人人口中的童年经历和婴儿的成长尚未审查。调查 慢性应激对母体下丘脑 - 垂体 - 肾上腺轴功能的影响以及母体和产科 结果很重要，因为这些机制可能位于慢性应激和婴儿之间的途径上 生长。美洲印第安人怀孕（SHAIP）研究的压力和健康与目标的目标保持一致 与美洲印第安人社区合作，土著创伤和弹性研究中心 与文化相关的研究。 Shaip研究将招募375名来自3个部落的美洲印第安妇女 北达科他州的社区，收集详细的生物学，医学和社交数据1妊娠期间 出生，产后6个月和产后12个月。在AIM 1中，我们将评估 怀孕期间的孕妇糖果和母体头发皮质醇浓度。在AIM 2中，我们将检验假设 母体头发皮质醇浓度介导了母体ac和母体和母体之间的关联 产科结果。最后，在AIM 3中，我们将检查孕产妇之间关系的多个调解人 ACE和婴儿的生长。这个拟议的研究项目将使我能够首次研究潜力 孕产妇和婴儿生长之间的途径。潜在可修改的介体，例如母乳喂养和 孕产妇的健康可能会为针对北部美洲印第安人人口的文化知情干预措施提供信息 达科他州。实现该项目的具体目标将使我能够确立自己的领先学者 孕产妇ACE和心脏代谢危险因素的代际传播。