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: 10350520
• 负责人: Micah Hahn
• 金额: $ 15.41万
• 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/10350520
• 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; Code; Communities; Data; Date of birth; Development; Ecology; Educational Background; 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; base; career; climate change; climate impact; comorbidity; disability; environmental justice; experience; financial relationship; 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.

项目概要（摘要） 该 K01 的研究目标是了解野火烟雾 (WFS) 暴露和其他孕产妇如何 不同社会人口群体的压力源汇聚在一起，对早产的影响也不同。早熟 是新生儿死亡和残疾的主要决定因素。美国存在着巨大的差异 美洲印第安人/阿拉斯加原住民妇女的早产率比全美所有妇女的早产率高 26% 妈妈们。该研究将包括三个具体目标。 （目标 1）：评估暴露之间的关联 阿拉斯加孕妇接受 WFS 和早产的情况。我们假设孕产妇 WFS 暴露是 与不良出生结果相关，特别是在关键发育窗口期暴露时 妊娠。我们将使用 NOAA HYSPLIT 模型开发一个历史的、空间明确的 WFS 图层。我们将 将模型输出与 2000 年至 2020 年 (n=220,000) 的阿拉斯加出生记录相结合，以估计之间的关联 WFS 暴露和出生结果，控制母亲吸烟、年龄、胎次和孕前共同因素 发病率。 （目标 2）：评估 WFS 暴露与不良分娩之间关系的效果修正 产妇特征、获得医疗保健的机会和地理偏远程度的结果。我们将利用 来自出生记录的信息进行分层分析。我们假设母亲的社会人口特征 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 怀孕期间的压力生活事件和早产时的 WFS 暴露。使用我们样本的子集 纳入怀孕风险评估监测系统 (PRAMS)，我们将通过以下方式纳入压力测量 领域（例如财务、关系）和压力生活事件的数量作为与 WFS 的交互变量 接触。该候选人是英国大学环境健康系的终身教授助理教授。 阿拉斯加-安克雷奇接受过流行病学、生物统计学、生态学方法和地理信息系统方面的培训。她的短暂职业生涯 目标是扩大她对野火流行病学的研究，并制定一个研究计划来了解 阿拉斯加的健康差异如何影响气候变化对健康的影响。她的长期职业目标是 领导一个应用研究小组，进行严格的、社区响应的研究。本次职业奖 将支持她在健康差异和混合方法研究、定性分析、高级 统计方法，以及将健康公平纳入适应规划。她的部门/导师团队有 环境流行病学、生物统计学、空气质量建模和转化研究方面的专业知识，以及她 校园提供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。这个提议 支持 NIMHD 通过加强严格的措施来改善少数族裔健康并减少健康差距的使命 定量和定性方法，以便能够对小群体进行分析并制定方法 在健康差异研究中纳入和使用地理标识符，以促进基于地方的研究。