Climate Change Impacts on Maternal Health in a Southern Birth Cohort: A Causal Analysis

气候变化对南方出生队列孕产妇健康的影响：因果分析

基本信息

批准号：
10373675
负责人：
Jennifer Runkle
金额：
$ 8.31万
依托单位：
NORTH CAROLINA STATE UNIVERSITY RALEIGH
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-08-23 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10373675
关键词：
Acute Address Air American College of Obstetricians and Gynecologists Area Birth Black race Centers for Disease Control and Prevention (U.S.)Chronic Climate Code Communities County Data Environmental Exposure Environmental Health Ethnic group Event Exhibits Exposure to Floods Foundations Future Generations Goals Green space Health Healthcare Heat Waves Human Hurricane Individual Infant Health International Intervention Knowledge Life Link Literature Maternal Health Maternal Mortality Measures Medical Medical Care Costs Monitor Mothers Multiple Pregnancy National Institute of Environmental Health Sciences Neighborhoods Newly Diagnosed Outcome Pathway interactions Patients Pattern Phase Poverty Predisposition Pregnancy Pregnancy Complications Pregnancy Outcome Pregnant Women Process Psychological Stress Race Recovery Relative Risks Research Risk Science Social Environment Societal Factors Strategic Planning Structural Racism Subgroup Temperature Testing Time Underweight United States National Institutes of Health Woman Work age group black women care burden career climate change climate crisis climate impact climate-related health cohort design disorder risk efficacy evaluation environmental stressor extreme heat hazard health disparity health inequalities health plan innovation maternal morbidity maternal risk premature prenatal protective factors racial difference racial disparity residential segregation resilience response severe maternal morbidity social social stressor stillbirth stress disorder stressor women faculty

项目摘要

PROJECT SUMMARY The American College of Obstetricians and Gynecologists recognizes that climate change is a significant health concern for pregnant women. Pregnancy is an understudied critical window, and few studies have examined the impact of the climate crisis on pregnant women and their unborn. Severe Maternal Morbidity (SMM) is currently a surveillance indicator used by the Centers for Disease Prevention and Control to measure and monitor improvements in maternal health; however, it has yet to be used in the context of climate change. SMM is a composite of 21 life-threatening conditions that arise during the process of labor and delivery. These conditions are known as “near miss” complications (i.e., an event in which a woman nearly dies) that result in significant medical care burden, including newly diagnosed chronic health conditions, psychological stress disorders, and amplified risks of maternal deaths. Black women are 2 times more likely to suffer from these life- threatening pregnancy complications, and the environmental causes of this important disparity are largely unknown and underexplored. An important science gap remains in identifying measures that elucidate climate and maternal health inequities, particularly for understanding the relationship between climate change and pregnancy risks among Black women in the South. This project will use a retrospective birth cohort to explore the causal linkages between the upstream social and environmental stressors and climate-related changes in maternal morbidity. Our long-term goal is to develop patient and healthcare interventions to reduce the impact of climate change during pregnancy. The overarching objectives of this exploratory study is to examine climate-sensitivity in SMM risk and advance understanding of the social-environmental drivers of racial inequalities in maternal morbidity. We will address this research gap with the following two specific aims: Aim 1. Examine patterns in SMM rates in response to three climate hazards--extreme heat, hurricanes, and inland flooding for a Southern birth cohort; Aim 2. Characterize the individual and neighborhood-level social (e.g., poverty, residential segregation) and environmental (e.g., greenspace) determinants that drive maternal health disparities in a changing climate. At the completion of this project, our expected outcomes are to 1) understand how the rate of SMM differs across different climate hazards and 2) elucidate the causal pathways linking climate change and maternal morbidity. The proposed research is significant because results will extend beyond identifying disease risks to capturing protective factors, as well as aid in hypothesis generation around pathways that contribute towards causal inference. This contribution is innovative since proposed results will provide new knowledge and a necessary first step in furthering understanding of the impacts of climate change on maternal health, providing the foundation for future studies on maternal health interventions and needed adaptations to climate change.

项目概要美国妇产科医师学会认识到气候变化是一个重大问题妊娠期是一个未被充分研究的关键时期，但很少有研究对此进行研究。研究了气候危机对孕妇及其胎儿的严重孕产妇发病率的影响。（SMM）目前是疾病预防控制中心用来衡量的监测指标并监测孕产妇健康的改善；然而，它尚未在气候变化的背景下使用。 SMM 是分娩过程中出现的 21 种危及生命的状况的综合。这种情况被称为“未遂”并发症（即女性差点死亡的事件），会导致沉重的医疗负担，包括新诊断的慢性疾病、心理压力黑人女性罹患这些疾病的可能性是女性的两倍。威胁妊娠并发症，而造成这一重要差异的环境原因很大程度上是未知且未充分探索。在确定阐明气候和孕产妇健康的措施方面仍存在重要的科学差距不平等，特别是了解气候变化与怀孕风险之间的关系该项目将利用回顾性出生队列来探索南方的黑人妇女之间的因果关系。上游社会和环境压力源与气候相关的孕产妇发病率变化之间的关系。我们的长期目标是制定患者和医疗保健干预措施，以减少气候变化的影响这项探索性研究的总体目标是检查怀孕期间的气候敏感性。 SMM 风险并加深对种族不平等的社会环境驱动因素的了解我们将通过以下两个具体目标来解决这一研究空白：目标 1. 检查应对三种气候灾害（极端高温、飓风和内陆洪水）的 SMM 率模式南方出生队列；目标 2. 描述个人和社区层面的社会特征（例如贫困、居住隔离）和推动孕产妇健康的环境（例如绿地）决定因素该项目完成后，我们的预期成果是 1) 了解气候变化中的差异。 SMM 的发生率在不同的气候灾害中有何不同，2) 阐明联系的因果路径拟议的研究意义重大，因为结果将延长。除了识别疾病风险之外，还包括捕捉保护因素，以及帮助生成假设有助于因果推理的途径这一贡献是创新的，因为提出的结果将提供新知识，并为进一步了解气候影响提供必要的第一步孕产妇健康的变化，为未来孕产妇健康干预研究奠定基础需要适应气候变化。