Shared Antecedents to Pre-term Birth and Cardiovascular Disease in Women

女性早产和心血管疾病的共同原因

• 批准号: 9903432
• 负责人: Janet M Catov
• 金额: $ 12.01万
• 依托单位: MAGEE-WOMEN'S RES INST AND FOUNDATION
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9903432
• 关键词: 37 weeks gestation; Address; Affect; Age; Area; Atherosclerosis; Biochemical; Biological Markers; Birth; Blood Pressure; C-reactive protein; Cardiac; Cardiovascular Diseases; Cause of Death; Cessation of life; Coronary Artery Risk Development in Young Adults Study; Data; Data Set; Detection; Development; Endothelium; Epidemiology; Fetal Growth Retardation; Foundations; Functional disorder; Gestational Diabetes; Goals; Health; Hypertension; Inflammation; Inflammatory; Intercellular adhesion molecule 1; Intervention; Left Ventricular Mass; Left Ventricular Remodeling; Life; Life Style; Link; Lipids; Measures; Metabolic Diseases; Modality; National Heart, Lung, and Blood Institute; Obesity; Outcome; Persons; Phenotype; Play; Predisposition; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Premature Birth; Prevention; Race; Recording of previous events; Recurrence; Risk; Role; Sampling; Structure; Surveys; TNF gene; Term Birth; Testing; Woman; Work; cardiometabolism; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; carotid intima-media thickness; comorbidity; coronary artery calcification; design; disorder risk; early screening; endothelial dysfunction; follow-up; gestational weight gain; high risk; improved; indexing; insight; maternal risk; middle age; novel; prepregnancy; prepregnancy obesity; primary outcome; prospective; reproductive; sex; young adult; young woman

PROJECT ABSTRACT Cardiovascular disease (CVD) is the leading cause of death among women and rates are rising in young women. Thus, prevention and early screening are essential. Women with preterm births (PTB) have excess CVD risk later in life compared to those with term births. It is unclear, however, if PTB unmasks, instigates or exacerbates a common predisposition. Mechanisms are not understood and pre-pregnancy measures are almost nonexistent. A few studies, including our own, raise the possibility that preterm birth may have lasting cardiometabolic effects that increase CVD risk, but longitudinal biomarker data have been unavailable to directly address this essential question. Inflammation and endothelial function are plausible but under-studied mechanisms linking PTB and CVD in women. The Coronary Artery Risk Development in Young Adults (CARDIA) study uniquely includes multiple assessments in women of reproductive age, both before and after pregnancies. Now in its third decade of follow-up with remarkably strong retention (72%), CARDIA will have conducted up to 9 in-person exams among 1,362 women (50% Black) who delivered 2,389 births from baseline to year 30. Uniquely, and just recently available, inflammatory and endothelial function markers have been measured in 900 CARDIA women from samples obtained both before and after pregnancies. We hypothesize that preterm birth is related to the pre-pregnancy profile, and additionally leaves a lasting pro-inflammatory signature that predisposes affected women to endothelial dysfunction, atherosclerosis and left ventricular remodeling. Our study aims are to 1) relate pre-pregnancy concentrations of high sensitivity C-reactive protein (hsCRP), soluble intercellular adhesion molecule-1 (s- ICAM) and tumor necrosis factor-α (TNF-α) to risk of PTB and determine if the change in these markers after delivery differs according to a history of PTB; and 2) evaluate the association of PTB and these profiles with atherosclerosis and cardiac remodeling in midlife. These novel studies will fill a major gap in our understanding of the link between PTB in susceptible women and the potential mechanisms underlying their increased risk of later CVD. These critical data will be the foundation for the discovery of novel mechanisms linking PTB to later CVD in women. The impact of this study is that it will be the first to use pre-pregnancy biomarkers of inflammation and endothelial function to understand the shared link between preterm birth and increased maternal risk of CVD later in life. These critical data will identify underlying inflammatory and endothelial mechanisms predisposing to both preterm birth and CVD in women, and pinpoint the timing and types of interventions needed to improve cardiovascular health in women.

项目摘要 心血管疾病（CVD）是妇女死亡的主要原因，年轻人的发生率正在上升 女性。那是必不可少的预防和早期筛查。早产（PTB）的妇女已超过 与有期限出生的人相比，CVD在生命之后的后期风险。但是，尚不清楚PTB是否揭露，煽动或 加剧常见的倾向。机制尚不清楚，怀孕措施是 几乎不存在。一些研究，包括我们自己的研究，提高了早产可能持久的可能性 心脏代谢效应会增加CVD风险，但纵向生物标志物数据却无法使用 直接解决这个基本问题。炎症和内皮功能是合理的，但研究不足 连接女性PTB和CVD的机制。年轻人的冠状动脉风险发展 （Cardia）独特的研究包括在生殖年龄的妇女的多次评估，无论是在 怀孕。现在，在其第三个十年的后续行动中，Cardia将拥有强大的保留率（72％）， 在1,362名妇女（50％黑色）中，最多9次面对面考试，她从 基准到30年。 我们是从妊娠前后获得的900名心脏病女性中测量的。 假设早产与孕前概况有关，另外还有持久 倾向于影响女性内皮功能障碍的促炎性签名， 动脉粥样硬化和左心室重塑。我们的研究目的是1）关联怀孕前 高灵敏度C反应蛋白（HSCRP）的浓度，固体间粘合分子1（S-） ICAM）和肿瘤坏死因子-α（TNF-α）降低了PTB的风险，并确定这些标记的变化是否在 交付根据PTB的历史而有所不同； 2）评估PTB的关联以及这些概况与 中年动脉粥样硬化和心脏重塑。这些新颖的研究将填补我们的理解差距 PTB在易感妇女中的联系与她们增加风险增加的潜在机制 后来CVD。这些关键数据将是发现将PTB连接到以后的新型机制的基础 女性的CVD。这项研究的影响是，它将是第一个使用孕前生物标志物的 炎症和内皮功能，以了解早产和增加之间的共同联系 孕产妇在以后的生活中出现CVD的风险。这些关键数据将识别潜在的炎症和内皮 女性的早产和CVD的机制，并确定了时间和类型 改善女性心血管健康所需的干预措施。