Hypertensive Disorders of Pregnancy and Early Risk of Maternal CVD: Influence of the External Exposome

妊娠期高血压疾病和孕产妇心血管疾病的早期风险：外部暴露的影响

• 批准号: 10523580
• 负责人: Hui Hu
• 金额: $ 13.41万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10523580
• 关键词: Hypertensive; Disorders; Pregnancy; Early; Risk

PROJECT SUMMARY Hypertensive disorders of pregnancy (HDP) are the most common pregnancy complication and are associated with an increased long-term risk of cardiovascular disease (CVD) which is also the leading cause of death for women in the US. Emerging evidence suggests that environmental exposure during pregnancy may play an important role in the development of HDP. However, several limitations exist, including 1) the ignorance of residential mobility during pregnancy in exposure assessments, 2) the lack of studies considering different subtype, onset, and severity of HDP, and 3) the lack of considerations of the totality of environment (i.e. the exposome). While HDP have been linked to long-term CVD risk after pregnancy, limited data are available on early maternal CVD risk (within the first five years after delivery) complicated by HDP. More importantly, no study has focused on the impact of environmental exposures during and after pregnancy on maternal CVD risk after pregnancy. In addition, risk assessment models of HDP predominantly rely on biomarkers that are not ubiquitously tested among all pregnant women, and no predictive model has been developed to identify women at higher CVD risk after pregnancy. This study builds on our prior work in the external exposome and leverages our access to the unique statewide linked electronic health records-birth records data from the OneFlorida Clinical Research Consortium to address multiple challenges in the field by: 1) determining the association between pregnancy external exposome and risk of HDP, considering the subtype, onset, and severity of HDP and accounting for pregnancy residential mobility in exposure measurements; 2) assessing early risk of maternal CVD after pregnancy associated with HDP and the external exposome, and 3) developing predictive models of HDP and early risk of maternal CVD after pregnancy. This research project will be embedded in a comprehensive training program consisting of coursework, guided experiential and clinical learning, seminars, and mentorship by an established team of experts. The training program is designed to further my strengths and to develop new research skills while contributing to our scientific understanding of environmental impacts on cardiovascular health among pregnant and postpartum women. The training proposal details a five-year plan of formal and informal instruction in cardiovascular health, omics and exposome research, biomedical informatics and data science, and professional skills. My short-term career goals include completing coursework in all training areas, disseminating study findings through publications and presentations, engaging in career development activities, and applying for independent R01 funding in the third year of the award. My long-term career goal is to become an independent, collaborative, and productive epidemiologist and health data scientist leading research programs in cardiovascular health, with a focus on its intersection with perinatal and environmental epidemiology using big data.

项目摘要 妊娠高血压疾病（HDP）是最常见的妊娠并发症，与之相关 患心血管疾病（CVD）的长期风险增加，这也是死亡的主要原因 在美国的妇女。新兴证据表明，怀孕期间的环境暴露可能会发挥 在HDP的发展中的重要作用。但是，存在几个限制，包括1） 在暴露评估中怀孕期间的住宅流动性，2）缺乏研究考虑不同的研究 HDP的亚型，发作和严重性，以及3）缺乏对环境的考虑（即 展览会）。虽然HDP与怀孕后的长期CVD风险有关，但可用于有限的数据 HDP复杂的早期母体CVD风险（在交货后的头五年内）。更重要的是，不 研究重点是怀孕期间和之后的环境暴露对母亲CVD风险的影响 怀孕后。此外，HDP的风险评估模型主要依赖于非生物标志物 在所有孕妇中均经过无处不在的测试，并且尚未开发任何预测模型来识别 怀孕后CVD风险较高的妇女。这项研究是基于我们在外部展览组中的先前工作和 利用我们访问全州范围内链接的电子健康记录出生记录数据的访问 Oneflorida临床研究联盟解决该领域的多个挑战：1）确定 考虑亚型，发作和 HDP的严重程度以及在暴露测量中考虑妊娠居民流动性； 2）评估 与HDP和外部杂物相关的妊娠后产妇CVD的早期风险，3） 在怀孕后开发HDP和母体CVD的早期风险的预测模型。该研究项目将 嵌入到一个全面的培训计划中，该计划由课程，指导性体验和临床组成 一群专家团队的学习，研讨会和指导。培训计划旨在 进一步我的优势和发展新的研究技能，同时为我们的科学理解做出贡献 环境对怀孕和产后妇女心血管健康的影响。培训 提案详细介绍了心血管健康，OMICS和 外界研究，生物医学信息学和数据科学以及专业技能。我的短期职业 目标包括在所有培训领域完成课程，通过出版物传播研究结果 和演讲，从事职业发展活动，并申请独立R01资金 奖励的第三年。我的长期职业目标是成为独立，协作和富有成效的 流行病学家和健康数据科学家心血管健康领先的研究计划，重点是 使用大数据与围产期和环境流行病学的交集。