Structural racism and cardiovascular disease risk in pregnant women and their infants

孕妇及其婴儿的结构性种族主义和心血管疾病风险

基本信息

批准号：
10674302
负责人：
Kim A Boggess
金额：
$ 15.93万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
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：
2022-12-07 至 2025-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10674302
关键词：
Address Aging American Heart Association Area Biological Biological Markers Black race Blood Vessels Cardiometabolic Disease Cardiovascular Diseases Career Mobility Characteristics Communities Complement Conceptions Crime Data Data Analyses Disparity Eclampsia Enrollment Environment Environmental Risk Factor Ethnic Origin Exposure to Food Access Foundations Future Geography Gestational Diabetes Goals Health Healthcare Hour Income Individual Inequality Infant Intervention Knowledge Learning Maternal Health Measures Mentors Mentorship Minority Women Mothers National Institute on Minority Health and Health Disparities Neighborhoods Parents Participant Patients Perinatal Physical environment Physiologic pulse Policies Positioning Attribute Postpartum Period Postpartum Women Poverty Pre-Eclampsia Pregnancy Pregnancy Complications Pregnant Women Prevalence Prevention Questionnaires Race Research Research Personnel Research Project Grants Risk Risk Factors Role Statistical Data Interpretation Structural Racism Third Pregnancy Trimester Time Underrepresented Minority United States United States National Institutes of Health Weight Woman arterial stiffness built environment cardiometabolic risk cardiometabolism cardiovascular disorder risk cardiovascular health career cohort combat deprivation disorder risk epidemiology study ethnic disparity ethnic diversity excessive weight gain experience health care quality infant outcome maternal morbidity medical complication mortality multidisciplinary parent grant post pregnancy pregnancy hypertension prenatal prepregnancy prevent programs racial discrimination racial disparity racial diversity racial health disparity residence residential segregation screening segregation severe maternal morbidity skills social statistics walkability

项目摘要

ABSTRACT In the United States, cardiovascular disease (CVD) is the leading cause of mortality in women, and the prevalence of cardiometabolic risk factors and cardiometabolic-related pregnancy complications are greater in Black and underrepresented women than White women. Race is a social construct and not biological, thus ethnicity/race alone cannot explain the disparities in cardiometabolic complications in pregnancy. These inequalities in cardiometabolic diseases during pregnancy may be explained in part by structural racism, which includes neighborhood environment and residential segregation. Yet, studies on structural racism and CVD risk are limited, particularly in pregnancy and the postpartum period. Therefore, the objective of this proposal is to understand whether structural racism is associated with CVD risk during pregnancy and postpartum among women and infants. This proposal supplements the Mother and Infant Determinants of vascular Aging Study (MIDAS; R01HL157075). The MIDAS study will enroll 840 racially/ethnically diverse healthy and medically complicated mother/infant dyads between 34-40 weeks’ gestation. At 34-40 weeks’ gestation, within 48 hours of delivery, and at 6 and 12 months postpartum, the MIDAS study will assess CVD risk by measuring pulse wave velocity (PWV), and examine relationships among biologic, personal, social, and ecological disease risk factors with PWV. Although neighborhood was a proposed CVD risk factor in the parent grant, this proposal will complement the existing MIDAS study by adding structural racism data and in-depth analysis of these data and CVD risk among women and infants. The study specific aims are to: 1) examine the association between structural racism and maternal arterial stiffness at the 3rd trimester in pregnancy and the trajectory to 1 year postpartum, and 2) determine the association between structural racism and infant arterial stiffness at 6 months and its change to 12 months. This time sensitive supplement leverages access to a large, diverse cohort of pregnant and postpartum women and their infants, and a multi-disciplinary team of mentors with expertise in CVD risk, maternal health, and racial health disparities. As a result, we are well positioned to complete the proposed aims. Additionally, this supplement will enable an early career investigator to: 1) gain experience conducting a well-defined research project evaluating CVD risk in pregnant women and their infants, 2) develop her knowledge on pregnancy-related cardiometabolic biomarkers and macro level risk factors (neighborhood and community-level), 3) further skills in statistical analysis and grantsmanship, and 4) expand her research network and learn from a successful mentorship team. This supplement will be an integral component to the MIDAS study by focusing on structural racism-related risk to maternal and infant cardiovascular health and it will provide an early career investigator with support to advance her career trajectory and establish an independent, fundable research line.

抽象的在美国，心血管疾病（CVD）是女性死亡的主要原因，心脏代谢危险因素和心脏代谢相关妊娠并发症的患病率更高黑人和白人女性的代表性不足，种族是一种社会建构，而不是生物学的，因此。仅凭种族/种族无法解释妊娠期心脏代谢并发症的差异。怀孕期间心脏代谢疾病的不平等可能部分是由结构性种族主义造成的，然而，关于结构性种族主义和心血管疾病风险的研究。是有限的，特别是在怀孕和产后期间。因此，该提案的目的是了解结构性种族主义是否与妊娠期和产后的 CVD 风险相关该提案补充了血管老化研究的母亲和婴儿决定因素。（MIDAS；R01HL157075）MIDAS 研究将招募 840 名具有不同种族/民族且身体健康的人。妊娠 34-40 周之间的复杂母婴二元体妊娠 34-40 周，48 小时内。 MIDAS 研究将在分娩时以及产后 6 个月和 12 个月时通过测量脉搏来评估 CVD 风险波速 (PWV)，并检查生物、个人、社会和生态疾病风险之间的关系尽管邻居是家长补助金中提出的 CVD 风险因素，但该提案将通过添加结构性种族主义数据并对这些数据进行深入分析来补充现有的 MIDAS 研究该研究的具体目的是：1）检查两者之间的关联。怀孕第三个月的结构性种族主义和母体动脉僵化以及到一年的轨迹产后，2) 确定结构性种族主义与 6 岁时婴儿动脉僵硬度之间的关联个月并更改为 12 个月，这种对时间敏感的补充利用了对大量、多样化的信息的访问。由孕妇和产后妇女及其婴儿组成的队列，以及由多学科导师组成的团队我们在 CVD 风险、孕产妇健康和种族健康差异方面拥有丰富的专业知识。此外，该补充材料将使早期职业调查员能够：1）获得收益。进行明确的研究项目评估孕妇及其孕妇的 CVD 风险的经验婴儿，2) 发展她对妊娠相关心脏代谢生物标志物和宏观风险的了解因素（邻里和社区层面），3) 统计分析和资助方面的进一步技能，以及 4) 扩大她的研究网络并向成功的导师团队学习该补充将是不可或缺的一部分。 MIDAS 研究的组成部分，重点关注孕产妇和婴儿的结构性种族主义相关风险心血管健康，它将为早期职业研究者提供支持，以促进她的职业生涯轨迹并建立一个独立的、可资助的研究线。