Iron and folic acid supplementation strategies during pregnancy and adverse pregnancy outcomes in Botswana

博茨瓦纳妊娠期间铁和叶酸的补充策略和不良妊娠结局

基本信息

批准号：
10459839
负责人：
Ellen Christina Caniglia
金额：
$ 13.27万
依托单位：
UNIVERSITY OF PENNSYLVANIA
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：
2021-08-01 至 2025-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10459839
关键词：
Address Adherence Adult Affect African Anemia Area Berry Birth Botswana Cause of Death Child Clinic Clinical Communicable Diseases Computer Simulation Country Data Demographic Factors Education Effectiveness Environment Epidemiologic Methods Evaluation First Pregnancy Trimester Folic Acid Formulation Geographic Factor Geographic Locations Gestational Age Goals Guidelines HIV HIV Seronegativity HIV Seropositivity Health Benefit Health system Income Individual Infant International Intervention Intervention Studies Interview Iron Knowledge Link Literature Low Birth Weight Infant Malaria Malnutrition Maternal and Child Health Measures Mentored Research Scientist Development Award Mentors Mentorship Methods Micronutrients Modification Neural Tube Defects Newborn Infant Outcome Pharmaceutical Preparations Policies Population Pregnancy Pregnancy Outcome Pregnant Women Premature Birth Proxy Qualitative Evaluations Qualitative Methods Qualitative Research Reading Recommendation Research Research Personnel Research Project Grants Resources Risk Risk Factors Sampling Science Sepsis Small for Gestational Age Infant Structure Subgroup Supplementation Time Training Underserved Population Underweight United Nations Woman Work World Health Organization adverse pregnancy outcome antenatal antenatal care base career career development community organizations compare effectiveness cost effective intervention data infrastructure design experience feasibility testing folic acid supplementation fortification high risk high risk population improved iron deficiency maternal weight medical schools prenatal prevent programs research and development side effect stillbirth surveillance data surveillance study symposium therapy development treatment strategy uptake

项目摘要

PROJECT SUMMARY Background. The risk of stillbirth, preterm delivery, low birthweight and other adverse pregnancy outcomes is extremely high in Sub-Saharan African countries including Botswana, especially among HIV-positive women. Daily iron and folic acid supplementation during pregnancy could reduce adverse pregnancy outcomes by reducing maternal anemia. However, the effectiveness of supplementation in subgroups defined by HIV status, anemia, gestational age, and other clinical, demographic and geographic factors remains unknown and compliance with supplementation guidelines is variable (<50% in Botswana). Cost-effective interventions to provide supplementation to pregnant women in Botswana and other resource-limited settings should be designed to address key barriers to successful supplementation and to reach subgroups that would benefit most from intervention. This K01 provides a unique opportunity to address this gap in the literature. Candidate Overview. My long-term career objective is to become an independent investigator who specializes in interventions to improve maternal and child health in resource-limited settings. My background is in applications of epidemiologic methods to evaluate effects of HIV treatment strategies in adults and infants. A K01 award will provide the necessary additional training and experience needed to become an expert in the design, implementation, and evaluation of interventions to improve pregnancy outcomes in HIV-positive women and underserved populations. Career Development and Training Plan. My education program includes structured course work, professional conferences, directed readings, and a research project with specific aims timed to coincide with these activities. My mentorship team includes international experts who specialize in areas related to my training goals: Dr. Scott Braithwaite (decision science), Dr. Roger Shapiro (HIV and maternal and child health in Botswana), Dr. Donna Shelley (intervention development and implementation), and Dr. Carolyn Berry (qualitative methods). Environment. NYU School of Medicine provides an exceptional environment for me to conduct the proposed study, obtain additional training and mentorship, and successfully transition to an independent investigator. Research Strategy. Using the data and infrastructure from an ongoing birth outcomes surveillance study in Botswana consisting of data from over 130,000 births, my study will: 1) estimate the effect of iron and folic acid supplementation during pregnancy on adverse pregnancy outcomes by HIV status, anemia, gestational age, and other key subgroups to identify populations that would benefit most from intervention; 2) assess barriers to supplementation during and prior to pregnancy; 3) optimize a hypothetical intervention to provide supplementation using computer simulation; and 4) develop and test the feasibility of an intervention to provide supplementation to pregnant women in Botswana.

项目摘要背景。死产，早产，低出生体重和其他不良怀孕结果的风险是在包括博茨瓦纳在内的撒哈拉以南非洲国家中，尤其是在艾滋病毒阳性妇女中极高。怀孕期间的每日铁和叶酸补充可以减少不良怀孕的结果减少孕产妇贫血。但是，补充在由艾滋病毒状况定义的亚组中的补充有效性，贫血，胎龄以及其他临床，人口和地理因素仍然未知，遵守补充指南是可变的（博茨瓦纳<50％）。具有成本效益的干预措施在博茨瓦纳和其他资源有限的环境中为孕妇提供补充旨在解决成功补充的关键障碍，并达到将有益的亚组大多数来自干预。该K01提供了一个独特的机会来解决文献中的这一差距。候选人概述。我的长期职业目标是成为专门研究的独立调查员在改善孕产妇和儿童健康的干预措施中，在资源有限的环境中。我的背景在流行病学方法评估成人和婴儿艾滋病毒治疗策略的影响的应用。一个 K01奖将为成为专家提供必要的额外培训和经验设计，实施和评估干预措施以改善HIV阳性的妊娠结局妇女和服务不足的人口。职业发展和培训计划。我的教育计划包括结构化课程工作，专业会议，定向阅读以及具有特定目的的研究项目，与这些活动。我的指导团队包括专门研究与我的领域的国际专家培训目标：Scott Braithwaite博士（决策科学），Roger Shapiro博士（艾滋病毒，母亲和儿童健康在博茨瓦纳），唐娜·雪莱（Donna Shelley）博士（干预开发和实施）和卡罗琳·贝里（Carolyn Berry）博士（定性方法）。环境。纽约大学医学学院为我提供了一个特殊的环境研究，获得额外的培训和指导，并成功过渡到独立的研究者。研究策略。使用正在进行的出生结果监视研究中的数据和基础设施博茨瓦纳由超过130,000个出生的数据组成，我的研究将：1）估计铁和叶酸的影响艾滋病毒状况，贫血，胎龄，在怀孕期间补充怀孕期间的补充，以及其他关键亚组，以确定将受益于干预措施最大的人群； 2）评估障碍在怀孕期间和怀孕之前补充； 3）优化假设的干预措施以提供使用计算机模拟补充； 4）开发和测试干预措施的可行性在博茨瓦纳补充孕妇。