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

环境空气污染、天气和胎盘早剥 (APWA)

• 批准号: 10649518
• 负责人: Cande V. Ananth
• 金额: $ 60.94万
• 依托单位: RUTGERS BIOMEDICAL AND HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-10 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10649518
• 关键词: Abruptio Placentae; Acute; Address; Affect; Air Pollutants; Air Pollution; Air Pressure; Ammonium; Area; Atmosphere; Big Data; Biological; Birth; Blood flow; Calibration; California; Carbon; Censuses; Chronic; Conceptions; Crossover Design; Data; Data Science; Databases; Diameter; Discipline of obstetrics; Elements; Environment; 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 Response; Inhalation; Ischemia; Linear Models; 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; Oxidative Stress; Ozone; Particulate Matter; Pathway interactions; Physiological; Placenta; Placenta Diseases; Pre-Eclampsia; Pregnancy; Pregnant Women; Premature Birth; Premature Rupture Fetal Membranes; Process; Public Health; Public Policy; Recurrence; Research; Residential Mobility; Resolution; Risk; Risk Factors; Role; Severities; Socioeconomic Status; South Carolina; Sulfate; Temperature; Time; United States National Institutes of Health; Uterine Contraction; Weather; Woman; ambient air pollution; cohort; cold temperature; design; early pregnancy; extreme heat; fetus hypoxia; fine particles; implantation; infant death; meter; obstetrical complication; perinatal outcomes; policy implication; pollutant; population based; predictive modeling; premature; prepregnancy; residence; spatiotemporal; stem; stillbirth; thrombotic

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 胎盘的破裂导致出血，缺血和胎儿缺氧，在这两个方面都有巨大的健康伯嫩 母亲和新生儿。理解这种毁灭性产科并发症的病因的努力已消除 - 指向。该项目将描述与环境相关的途径，以确定政治的影响 急性与慢性斑点破裂实现的诱因。考虑到所有破裂案件的四分之一 具有急性病因，15％的破裂可能会在未来的怀孕中复发，环境触发器的作用是 至关重要但出乎意料的机会，了解这种神秘的产科综合的病理生理学 阳离子。该项目将利用高分辨率的敞口和健康结果数据，因为它旨在建立出生联系 数据库，其中包括与死产和现场生产的死亡相关的医院，妇女的居民死亡 加利福尼亚，佛罗里达州，马萨诸塞州，密歇根州和南卡罗来纳州（估计有1600万个出生，包括155,000 案例）在2000 - 2016年之间。对于每个怀孕，我们将平均每日环境暴露于细节 具有空气动力学直径≤2.5µm（PM2.5），其一致（元素碳和有机碳，硫酸盐，硝酸盐，硝酸盐， 和铵）以及气态污染物（二氧化氮和臭氧），使用时空分辨的模型 预测每个住宅位置的曝光率。我们还将以平均每日温度（潮湿）分配每个住所 它，露点，热浪和大气气压。该项目将着重于解开相对贡献 环境空气污染和与天气相关的条件在急性破裂时通过双向分解的病例 跨界设计，以及使用队列设计的慢性基础的破裂。我们将应用分布式滞后 线性和非线性模型以识别曝光的关键窗口，贝叶斯内核机回归以表征 基于多污染物暴露的关联以及因缺血性分析因果关系分析 斑点疾病（先兆子痫，胎儿生长障碍）。我们将考虑个人和邻里 - 源自居民人口普查区的创始人。所有关联将予以纠正以简单暴露和结果 由于母亲居民通过回归而导致的流动性，错误分类以及暴露测量误差 校准方法。空气污染和天气暴露及其对广告的潜在影响的无处不在 围产期结果以及支持关联的初步数据，为前所未有的机会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位置的不利影响的影响 相关的产科并发症。该项目与研究 - 曝光的两个主要关键领域和数据相吻合 NIH国家环境健康科学研究所的2018 - 2023年战略目标中的ENCE和大数据划分。