Project 2: Disparities-Aware Classifiers for Maternal and Infant Health

项目 2：母婴健康差异感知分类器

基本信息

批准号：
10376065
负责人：
ELAINE SYMANSKI
金额：
$ 43.4万
依托单位：
BAYLOR COLLEGE OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-07-16 至 2025-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10376065
关键词：
Affect African American Area Aromatic Polycyclic Hydrocarbons Awareness Behavior Biological Biological Factors Blood Cells Characteristics Chemicals Cities Clinical Complex County Data Development Disasters Eclampsia Economics Enrollment Environmental Health Ethnic group Evaluation Exposure to Family Goals Hazardous Waste Sites Health Home Hypertension Individual Industrialization Infant Infant Health Intervention Maternal Health Maternal and Child Health Medicine Metadata Metal exposure Metals Minority Morbidity - disease rate Neighborhoods Neonatal Mortality Not Hispanic or Latino Outcome Pediatric Hospitals Personal Satisfaction Physical environment Population Populations at Risk Postpartum Period Poverty Pre-Eclampsia Pregnancy Pregnant Women Premature Birth Prevalence RNA Race Reproductive History Research Research Project Grants Resources Rest Risk Risk Factors Second Pregnancy Trimester Social Environment Specific qualifier value Testing Texas Third Pregnancy Trimester Time Validation Vulnerable Populations Woman Women&apos s Health built environment college economic cost environmental health disparity health care quality health disparity health disparity populations improved interest maternal risk microbiome model development mortality risk multi-ethnic multi-racial neonatal morbidity obstetric outcomes pregnancy disorder pregnancy hypertension prospective psychosocial stressors racial determinant racial disparity racial population sociodemographics socioeconomic disadvantage stressor

项目摘要

ABSTRACT A woman’s wellbeing during pregnancy affects her short- and long-term health as well as that of her infant. In fact, preterm delivery is a leading indicator of health in the U.S. because of its devastating impacts on neonatal mortality and morbidity with estimated economic costs that exceed 25 billion dollars each year. Despite advances over the last decade in reducing the annual prevalence of preterm birth to under 10%, persistent racial inequities remain that pose significant challenges to improving maternal and child health among health disparity populations in the U.S. Hypertensive disorders of pregnancy (HDP), which consist of eclampsia, preeclampsia and gestational hypertension, affect up to 10% of pregnancies and, like preterm delivery, increase maternal risks of mortality and morbidity that extend far beyond post-partum periods. Significant racial disparities exist, with African-American (AA) women at greatest risk for preterm birth and for dying from HDP than any other racial or ethnic group in the U.S. Traditional risk factors (e.g., maternal sociodemographic characteristics, behaviors, reproductive history and access to quality health care) do not fully explain racial disparities in preterm birth or other obstetric outcomes. To elucidate determinants of these racial disparities, we must consider aspects of the broader biological, physical, social and built environments that may affect women’s health, and move toward an integrated assessment of these factors to more accurately predict risk. Pregnant women in Houston are an at risk population. As a petrochemical hub and fourth largest city in the U.S., Houston is a microcosm for identifying factors of the biological, physical, social, and built environments that constitute the “environmental riskscape”. Defining riskscape features underlying preterm birth and other obstetric outcomes will inform our understanding of determinants of racial disparities in these outcomes in Houston and for disparity populations across the nation. The overall Objective of this Research Project, Disparities-aware Classifiers for Maternal and Infant Health, is to develop “disparities-aware” classifiers that identify major drivers of preterm birth and HDP using an inclusive environmental riskscape framework. To do so, we will conduct a study building upon the unique PeriBank resource at Baylor College of Medicine to acquire data on maternal biological [circulating cell-free RNA (cfRNA) and microbiome] and chemical (PAH and metal) exposures, as well as features of the social and built environments. These data will be used to identify informative features that can be integrated into AA and non- Hispanic white (NHW) disparities-aware classifiers for preterm birth and HDP. Predictive disparities-aware classifiers that rely on attributes of individual- and place-level stressors have the potential for identifying major drivers of preterm birth and HDP among AA and NHW women and provide direction for developing interventions to mitigate disparities and improve the health and well-being of women and their infants.

抽象的女性在怀孕期间的健康状况会影响其短期和长期健康以及婴儿的健康。事实上，早产是美国健康的一个主要指标，因为它对新生儿造成毁灭性影响死亡率和发病率估计每年造成的经济损失超过 250 亿美元。过去十年中，在将早产率每年降低至 10% 以下方面取得了进展，持续存在的种族问题不平等仍然存在，对改善健康差距中的孕产妇和儿童健康构成重大挑战美国妊娠高血压疾病 (HDP) 人群，包括子痫、先兆子痫和妊娠高血压，影响高达 10% 的妊娠，并且与早产一样，会增加孕产妇风险死亡率和发病率远远超出产后时期，存在显着的种族差异。非裔美国 (AA) 妇女早产和死于 HDP 的风险比任何其他种族或种族的妇女都高美国的族裔群体传统的危险因素（例如，母亲的社会人口特征、行为、生育史和获得优质医疗保健的机会）并不能完全解释早产或早产的种族差异为了阐明这些种族差异的决定因素，我们必须考虑以下几个方面。可能影响女性健康的更广泛的生物、物理、社会和建筑环境，并走向对这些因素进行综合评估可以更准确地预测休斯顿的孕妇的风险。作为石化中心和美国第四大城市，休斯顿是识别风险人群的一个缩影。构成“环境风险景观”的生物、物理、社会和建筑环境因素。定义早产和其他产科结局的风险特征将有助于我们理解休斯顿这些结果以及全国差异人口的种族差异的决定因素。该研究项目的总体目标，母婴健康差异感知分类器，是开发“差异意识”分类器，使用包容性的方法识别早产和 HDP 的主要驱动因素为此，我们将在独特的 PeriBank 基础上进行一项研究。贝勒医学院的资源，用于获取母体生物数据[循环游离 RNA (cfRNA) 微生物组]和化学物质（多环芳烃和金属）暴露，以及社会和建筑的特征这些数据将用于识别可集成到 AA 和非环境中的信息功能。西班牙裔白人 (NHW) 早产差异感知分类器和 HDP 预测差异感知。依赖于个人和地方层面压力源属性的分类器有可能识别主要压力源 AA 和 NHW 妇女早产和 HDP 的驱动因素，并为制定干预措施提供指导缩小差距并改善妇女及其婴儿的健康和福祉。