Long-Term Burden of Maternal Cardiovascular Risk Factors and Birth Outcomes

母亲心血管危险因素和出生结果的长期负担

• 批准号: 8906533
• 负责人: Emily Wheeler Harville
• 金额: $ 51.94万
• 依托单位: TULANE UNIVERSITY OF LOUISIANA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-05 至 2017-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8906533
• 关键词: Accounting; Adolescence; Adult; Birth; Birth Weight; Blood Pressure; Body mass index; Cardiovascular system; Child; Childhood; Cholesterol; Communities; Data; Diabetes Mellitus; Dyslipidemias; Fetal Growth Retardation; Gestational Age; Gestational Diabetes; Glucose; Goals; Heart; Hyperglycemia; Hyperinsulinism; Hypertension; Incidence; Individual; Intervention; Interview; Lead; Life Cycle Stages; Link; Longevity; Medical Records; Metabolic syndrome; Mothers; Obesity; Outcome; Participant; Population; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Histories; Pregnancy Outcome; Premature Birth; Public Health; Records; Reproductive Health; Research; Risk; Risk Factors; Running; Time; Woman; Work; base; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; emerging adult; health disparity; improved; modifiable risk; novel; offspring; pregnancy disorder; pregnancy hypertension; racial disparity; reproductive; young adult

DESCRIPTION (provided by applicant): Few modifiable risk factors for preterm birth (PTB) and intrauterine growth retardation (IUGR) have been identified. Poor cardiovascular health during the pregnancy can lead to preterm birth (PTB), but the effect of pre-pregnancy cardiovascular health on birth outcomes is not clear. Our long-term goal is to determine the causes of and ultimately develop interventions that can reduce the incidence of and disparities in PTB/IUGR. Our overall objective with this project is to determine the relationship between pre-pregnancy cardiovascular risk, from childhood through early adulthood, and birth outcomes. Our central hypothesis is that high cardiovascular risk across the lifespan predicts poor pregnancy outcome and partially accounts for racial disparities in these outcomes. We plan to take advantage of the data collected in the Bogalusa Heart Study, a long-running biracial (black/white) study of cardiovascular health in children and young adults. The study includes data on almost 6000 women, now in their late reproductive years. We propose to link to vital records data (estimated N=3980), interview participants about their pregnancy history (estimated N=3060), and request medical records for their pregnancies (estimated N=1330). We will then examine the relationship between cardiovascular disease (CVD) risk factors across the lifespan, birth outcomes, and pregnancy complications. Our specific aims are 1. To determine the impact of mother's CVD risk factors (high blood pressure, dyslipidemia, hyperglycemia, hyperinsulinemia, obesity) in childhood and adolescence on birth outcomes of her babies (preterm birth (PTB) and intrauterine growth retardation (IUGR)) in a black and white population; 2) To examine the relationship of longitudinal changes of mother's CVD risk factors from childhood to adulthood to birth outcomes in black and white individuals); 3) To determine whether pre-pregnancy CVD risk factors are associated with pregnancy complications (gestational hypertension, gestational diabetes and pre-eclampsia), and whether this explains the relationship between pre-pregnancy cardiovascular risk and PTB/IUGR; 4) To determine whether differences in CVD risk factors explain racial disparities in birth outcomes. The contribution of the proposed research is expected to be linking pre-pregnancy cardiovascular health across the life span with pregnancy outcomes. This will be significant because we will identify novel risk factors, timing, and subpopulations for interventions that could reduce the incidence of and disparities in PTB/IUGR. This proposal takes advantage of the unique opportunity to use 35 years of longitudinal research, beginning in childhood, in a biracial population.

描述（由申请人提供）：已确定很少有可改变的早产（PTB）和宫内生长迟缓（IUGR）风险因素。怀孕期间心血管健康状况不佳可导致早产（PTB），但孕前心血管健康对出生结局的影响尚不清楚。我们的长期目标是确定原因并最终制定干预措施，以减少 PTB/IUGR 的发生率和差异。我们该项目的总体目标是确定从儿童期到成年早期的孕前心血管风险与出生结果之间的关系。我们的中心假设是，整个生命周期的高心血管风险预示着妊娠结局不佳，并部分解释了这些结局中的种族差异。我们计划利用 Bogalusa 心脏研究中收集的数据，这是一项针对儿童和年轻人心血管健康的长期双种族（黑人/白人）研究。该研究涵盖了近 6000 名处于生育后期的女性的数据。我们建议链接到重要记录数据（估计 N=3980），采访参与者有关其怀孕史（估计 N=3060），并索取其怀孕的医疗记录（估计 N=1330）。然后，我们将研究整个生命周期中心血管疾病 (CVD) 危险因素、出生结果和妊娠并发症之间的关系。我们的具体目标是 1. 确定母亲在儿童期和青春期的 CVD 危险因素（高血压、血脂异常、高血糖、高胰岛素血症、肥胖）对其婴儿出生结局（早产 (PTB) 和宫内生长迟缓 (IUGR)）的影响)) 在黑人和白人群体中； 2）研究母亲CVD危险因素从童年到成年的纵向变化与黑人和白人出生结果的关系； 3）确定孕前CVD危险因素是否与妊娠并发症（妊娠高血压、妊娠糖尿病和先兆子痫）相关，以及这是否解释了孕前心血管风险与PTB/IUGR之间的关系； 4) 确定CVD危险因素的差异是否可以解释出生结果的种族差异。拟议研究的贡献预计将是将整个生命周期的孕前心血管健康与妊娠结局联系起来。这将具有重要意义，因为我们将确定新的风险因素、时机和干预亚群，以减少 PTB/IUGR 的发生率和差异。该提案利用了从童年开始对混血人群进行 35 年纵向研究的独特机会。