Ambient Air Pollution, Weather, and Placental Abruption (APWA)

环境空气污染、天气和胎盘早剥 (APWA)

基本信息

批准号：
10487587
负责人：
Cande V. Ananth
金额：
$ 64.27万
依托单位：
RBHS-ROBERT WOOD JOHNSON MEDICAL SCHOOL
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：
2021-09-10 至 2023-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10487587
关键词：
Abruptio Placentae Acute Address Affect Air Pollutants Air Pollution Air Pressure Ammonium Area Big Data Biological Birth Blood flow Caliber Calibration California Carbon Censuses Chronic Conceptions Crossover Design Data Data Science Databases Discipline of obstetrics Etiology Event Exposure to Fetal Growth Fetal Growth Retardation Fetal Heart Rate First Pregnancy Trimester Florida Functional disorder Future Gestational Diabetes Goals Health Heat Waves Hemorrhage High temperature of physical object Hospitals Humidity Individual Inflammatory Inhalation Ischemia Link Live Birth Location Massachusetts Measurement Mediating Mediation Michigan Mothers National Institute of Environmental Health Sciences Nature Neighborhoods Newborn Infant Nitrates Nitrogen Dioxide Non-linear Models Outcome Ozone Particulate Matter Partner in relationship Pathway interactions Physiological Placenta Placenta Diseases Pre-Eclampsia Pregnancy Pregnant Women Premature Birth Premature Rupture Fetal Membranes Process Public Health Research Residential Mobility Resolution Risk Risk Factors Role Severities Socioeconomic Status South Carolina Sulfate Temperature Time United States National Institutes of Health Ursidae Family Uterine Contraction Weather Woman ambient air pollution base cohort cold temperature design early pregnancy extreme heat fetus hypoxia fine particles implantation infant death obstetrical complication perinatal outcomes policy implication pollutant population based predictive modeling premature prepregnancy residence spatiotemporal stem stillbirth thrombotic

项目摘要

ABSTRACT Placental abruption results in hemorrhage, ischemia, and fetal hypoxia, placing a tremendous health burden on both the mother and the newborn. Efforts to understand the etiology of this devastating obstetrical complication have been disap- pointing. This project will delineate environmentally-associated pathways to abruption and determine the impact of pol- lutant triggers that are implicated in acute versus chronic placental abruption. Given that one-fourth of all abruption cases have an acute etiology and 15% of abruptions may recur in future pregnancies, the role of environmental triggers is a critically important, yet unexplored, opportunity to understand the pathophysiology of this enigmatic obstetrical compli- cation. The project will capitalize on high resolution exposure and health outcome data as it aims to develop a birth linkage database that will include hospital discharges linked to both stillbirths and live births-infant deaths to resident women in California, Florida, Massachusetts, Michigan, and South Carolina (estimated 16 million births, including 155,000 abruption cases) between 2000–2016. For each pregnancy we will assign average daily ambient exposure to fine particulate matter with an aerodynamic diameter ≤2.5 µm (PM2.5), its constituents (elemental carbon and organic carbon, sulfate, nitrate, and ammonium), as well as gaseous pollutants (nitrogen dioxide and ozone), using spatiotemporally resolved models that predict exposure for each residential location. We will also assign every residence with average daily temperature, humid- ity, dew point, heat waves, and atmospheric air pressure. The project will focus on disentangling the relative contributions of ambient air pollution and weather-related conditions on acute abruption through a bi-directional, time-stratified case- crossover design, and those of abruptions with chronic underpinnings using a cohort design. We will apply distributed lag linear and non-linear models to identify critical windows of exposure, Bayesian Kernel Machine Regression to characterize associations based on multi-pollutant exposures, and causal interaction-mediation decomposition analyses through ischemic placental disease (preeclampsia, fetal growth disturbances). We will consider individual– and neighborhood–level con- founders derived from residential census tracts. All associations will be corrected for simultaneous exposure and outcome misclassification, as well as for exposure measurement error owing to maternal residential mobility through a regression calibration approach. The ubiquitous nature of air pollution and weather exposures and their potential impact on adverse perinatal outcomes, as well as the preliminary data supporting the associations, presents unprecedented opportunities to address implications of the adverse impact of air pollution and weather-related exposures on placental abruption and related obstetrical complications. This project aligns with 2 major critical areas of research–Co-exposures, and Data Sci- ence and Big Data–outlined in the 2018-2023 strategic goals of NIH-National Institute of Environmental Health Sciences.

抽象的胎盘早剥会导致出血、缺血和胎儿缺氧，给胎儿和胎儿带来巨大的健康负担。了解这种毁灭性产科并发症的病因的努力已经失败。该项目将描绘与环境相关的中断途径并确定污染的影响。考虑到四分之一的胎盘早剥病例涉及急性与慢性胎盘早剥。具有急性病因，并且 15% 的胎盘早剥可能会在未来怀孕中再次发生，环境触发因素的作用是这是了解这一神秘产科并发症的病理生理学的至关重要但尚未探索的机会该项目将利用高分辨率暴露和健康结果数据，旨在建立出生联系。数据库将包括与死产和活产相关的出院情况——居民妇女的婴儿死亡加利福尼亚州、佛罗里达州、马萨诸塞州、密歇根州和南卡罗来纳州（预计出生人数 1,600 万，其中出生人数 155,000 人）对于 2000 年至 2016 年期间的每次怀孕，我们将分配平均每日环境细颗粒物暴露量。空气动力学直径≤2.5 µm (PM2.5)，其成分（元素碳和有机碳、硫酸盐、硝酸盐、和铵），以及气态污染物（二氧化氮和臭氧），使用时空解析模型我们还将为每个住宅区分配日平均温度、湿度。该项目将侧重于理清相对贡献。通过双向、时间分层的案例来研究环境空气污染和天气相关条件对急性突变的影响交叉设计，以及使用队列设计的具有慢性基础的中断我们将应用分布式滞后。线性和非线性模型来识别关键暴露窗口，贝叶斯核机器回归来表征基于多污染物暴露的关联，以及通过缺血进行因果相互作用介导分解分析我们将考虑个人和社区层面的胎盘疾病（先兆子痫、胎儿生长障碍）。来自住宅人口普查区的创始人将针对同时曝光和结果进行纠正。错误分类，以及由于母亲居住流动性导致的暴露测量误差校准方法。空气污染和天气暴露的普遍性及其对不利影响的潜在影响。围产期结局以及支持这些协会的初步数据提供了前所未有的机会解决空气污染和与天气相关的暴露对胎盘早剥的不利影响的影响该项目符合两个主要的关键研究领域——共同暴露和数据科学。环境与大数据——NIH-国家环境健康科学研究所 2018-2023 年战略目标中概述。