Convergence of multiple exposures during pregnancy: Effect of wildfires and maternal stressors on birth outcomes among Alaskan women

怀孕期间多重暴露的汇集：野火和母亲压力源对阿拉斯加妇女出生结果的影响

• 批准号: 10552646
• 负责人: Micah Hahn
• 金额: $ 15.37万
• 依托单位: UNIVERSITY OF ALASKA ANCHORAGE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-19 至 2026-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10552646
• 关键词: Accounting; Age; Air; Alaska; Alaska Native; Alaskan; American Indians; Applied Research; Award; Biometry; Birth; Birth Records; Cessation of life; Characteristics; Child Development; Communities; Critical Thinking; Data; Date of birth; Development; Disparity; Ecology; Education; Educational Status; Environmental Epidemiology; Environmental Exposure; Environmental Health; Environmental Risk Factor; Epidemiology; Exposure to; Faculty; Family; Fetal Development; Future; Geography; Goals; Health; Health Disparities Research; Incidence; Insurance Coverage; Interdisciplinary Study; Intervention; Joints; K-Series Research Career Programs; Lead; Life Cycle Stages; Measures; Medical; Mentors; Mentorship; Methodology; Methods; Mission; Modeling; Modification; Monitor; Mothers; National Institute on Minority Health and Health Disparities; National Oceanic and Atmospheric Administration; Neonatal Mortality; Outcome; Output; Population; Pregnancy; Pregnant Women; Premature Birth; Prenatal care; Public Health; Qualitative Methods; Race; Reduce health disparities; Research; Research Institute; Research Methodology; Research Personnel; Resources; Risk; Risk Assessment; Risk Factors; Role; Rural; Rural Community; Sampling; Smoke; Source; Statistical Methods; Stress; Stressful Event; System; Testing; Time; Training; Training Support; Translational Research; Universities; Wildfire; Woman; Work; adverse birth outcomes; career; climate change; climate impact; comorbidity; disability; environmental justice; experience; health care availability; health disparity; health equity; improve minority health; maternal cigarette smoking; maternal outcome; maternal stress; neonatal death; novel; parity; premature; prepregnancy; professor; programs; public health relevance; remote communities; residence; response; social; social factors; sociodemographic group; sociodemographics; socioeconomics; stressor; success; tenure track

PROJECT SUMMARY (ABSTRACT) The research objective of this K01 is to understand how wildfire smoke (WFS) exposure and other maternal stressors converge and contribute to preterm birth differentially across socio-demographic groups. Prematurity is a major determinant of newborn death and disability. There are substantial disparities in the U.S. where the rate of preterm births among American Indian/Alaska Native women is 26% higher than the rate among all U.S. mothers. The research will consist of three Specific Aims. (Aim 1): Evaluate the association between exposure of pregnant women in Alaska to WFS and preterm birth. We hypothesize that maternal WFS exposure is associated with adverse birth outcomes, particularly when exposed at critical developmental windows during gestation. We will develop a historical, spatially explicit WFS layer using the NOAA HYSPLIT model. We will combine model output with Alaskan birth records from 2000-2020 (n=220,000) to estimate associations between WFS exposure and birth outcomes, controlling for maternal smoking, age, parity, and pre-pregnancy co- morbidities. (Aim 2): Assess effect modification of the relationship between WFS exposure and adverse birth outcomes by maternal characteristics, access to healthcare, and geographic remoteness. We will utilize information from birth records to conduct stratified analyses. We hypothesize that maternal socio-demographic characteristics modify the relation between WFS exposure and birth outcomes. (Aim 3): Test the combined effect of stressful life events during pregnancy and WFS exposure on preterm birth. Using a subset of our sample included in the Pregnancy Risk Assessment Monitoring System (PRAMS), we will include measures of stress by domain (e.g. financial, relationship) and number of stressful life events as interaction variables with WFS exposure. The candidate is a tenure-track Assistant Professor of Environmental Health at the University of Alaska-Anchorage with training in epidemiology, biostatistics, ecology methods, and GIS. Her short-term career goals are to expand her research on wildfire epidemiology, and to develop a research program to understand how health disparities in Alaska contribute to the health impacts of climate change. Her long-term career goal is to lead an applied research group that conducts rigorous, community-responsive research. This career award will support her training in health disparities and mixed methods research, qualitative analysis, advanced statistical methods, and integration of health equity into adaptation planning. Her department/mentor team have expertise in environmental epidemiology, biostatistics, air quality modeling, and translational research, and her campus offers many opportunities to support junior faculty. These experiences and resources will support the work proposed here, as well as future interdisciplinary research on environmental justice issues. This proposal supports the NIMHD mission to improve minority health and reduce health disparities by strengthening rigorous quantitative and qualitative methods to enable analysis on small populations and developing methodologies for incorporating and using geographic identifiers in health disparities research to promote place-based research.

项目摘要（摘要） 该K01的研究目标是了解野火烟雾（WFS）如何暴露和其他母亲 压力汇聚并在社会人口统计学群体中差异地促进早产。早熟 是新生儿死亡和残疾的主要决定因素。在美国存在很大的差异 美洲印第安人/阿拉斯加原住民妇女的早产率比美国所有美国的比率高26％ 母亲。该研究将由三个具体目标组成。 （AIM 1）：评估曝光之间的关联 阿拉斯加的孕妇为WFS和早产。我们假设母体WFS的暴露是 与不良的出生结果相关，尤其是在关键的发育窗口中暴露时 妊娠。我们将使用NOAA HySplit模型开发历史上的显式WFS层。我们将 将模型输出与2000 - 2020年的阿拉斯加出生记录（n = 220,000）相结合，以估算 WFS暴露和出生结果，控制孕产妇的吸烟，年龄，奇偶校验和怀孕前共同 病态。 （AIM 2）：评估WFS暴露与不良出生之间关系的效果修改 孕产妇特征，获得医疗保健和地理偏远的结果。我们将利用 从出生记录到进行分层分析的信息。我们假设孕产妇的社会人口统计学 特征改变了WFS暴露与出生结果之间的关系。 （目标3）：测试综合效果 怀孕期间的压力性生活事件和早产的WFS暴露。使用样本的子集 包括怀孕风险评估监测系统（PRAM）中，我们将通过 域（例如财务，关系）和压力大的生活事件的数量作为与WFS的互动变量 接触。候选人是大学的终身轨道助理教授 阿拉斯加 - 分割疗法，包括流行病学，生物统计学，生态学方法和GIS的培训。她的短期职业 目标是扩大她对野火流行病学的研究，并制定研究计划以了解 阿拉斯加的健康差异如何促进气候变化的健康影响。她的长期职业目标是 领导一个应用严格的社区响应研究的应用研究小组。这个职业奖 将支持她在健康差异和混合方法研究，定性分析，高级方面的培训 统计方法，并将健康公平整合到适应计划中。她的部门/导师团队有 环境流行病学，生物统计学，空气质量建模和翻译研究方面的专业知识，她 校园提供了许多支持初级教师的机会。这些经验和资源将支持 这里提出的工作以及未来关于环境正义问题的跨学科研究。这个建议 支持NIMHD的使命，以改善少数民族健康并通过加强严格的健康差异 定量和定性方法，以对少数人群进行分析，并开发方法 在健康差异研究中纳入并使用地理标识符来促进基于场所的研究。