Impact of prenatal exposure to climate stressors and severe maternal morbidity: a retrospective birth cohort study

产前暴露于气候压力源和严重孕产妇发病率的影响：一项回顾性出生队列研究

• 批准号: 10648271
• 负责人: Jennifer Runkle
• 金额: $ 8.4万
• 依托单位: NORTH CAROLINA STATE UNIVERSITY RALEIGH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-16 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10648271
• 关键词: Academy; American; Attention; Birth; Characteristics; Child; Climate; Clinic; Cohort Studies; Communities; Data Analyses; Death Rate; Discipline of obstetrics; Disparity; Environmental Exposure; Environmental Risk Factor; Event; Exposure to; Gender; Generations; Gestational Diabetes; Goals; Gynecology; Health; Health Status; Health protection; Heat Waves; Human; Hypertension; Infant; Infant Health; Intervention; Joints; Knowledge; Life; Light; Literature; Maternal Health; Maternal Mortality; Measures; Mental disorders; Monitor; Outcome; Pathway interactions; Patients; Pediatrics; Policies; Population; Population Study; Population Surveillance; Poverty; Predisposition; Pregnancy; Premature Birth; Public Health; Reporting; Research; Risk; Science; Social Environment; Subgroup; United States; United States National Institutes of Health; Urbanization; Vulnerable Populations; Woman; Work; World Health Organization; age group; climate change; climate crisis; climate impact; climate-related health; cohort; college; cost; critical period; design; efficacy evaluation; environmental stressor; evidence based guidelines; extreme heat; extreme temperature; extreme weather; health disparity; improved; in utero; innovation; negative affect; neonatal health; population based; pregnancy disorder; pregnant; prenatal; prenatal exposure; public health intervention; residential segregation; resilience; response; severe maternal morbidity; social; social factors; social health determinants; social stressor; sound; stressor; trend

PROJECT SUMMARY The climate crisis, in combination with other social and environmental stressors, negatively influences human health; its impact varies across age groups and life stages. Pregnancy is an understudied critical window of susceptibility. Few studies have focused on the impact of prenatal exposure to climate stressors on pregnant populations and infants in the Southeastern US, despite pronounced trends in climate warming, an escalating maternal death rate, and persistent maternal and infant health disparities in the region. An important science gap remains in identifying national climate change and health surveillance indicators, particularly for understanding the relationship between climate change and pregnancy risks. Our long-term goal is to develop clinic-based and public health interventions to reduce the adverse impact of climate change during pregnancy. The overarching goal of this population-based study is to examine extreme temperature-sensitivities in maternal and infant health risk during critical windows of pregnancy and advance understanding of the social-environmental drivers of health disparities in a changing climate. We will achieve the following two specific aims: Aim 1. Characterize the relationship between exposure to cold and hot ambient temperature extremes and adverse maternal and infant health outcomes during critical periods of pregnancy; Aim 2. Examine the joint effects of prenatal exposure to temperature extremes and socio-environmental stressors on excess maternal and infant health risks. The new NIH Climate Change and Health Strategic Initiative has prioritized protecting the health of pregnant populations in the face of extreme temperatures. This low-cost retrospective birth cohort study will advance understanding on how social and environmental conditions that occur during pregnancy interact with climate change stressors to negatively affect the health of pregnant populations and their infants. Our expected outcomes will include: 1) the quantification of prenatal exposure to climate change as a risk multiplier during pregnancy; and 2) the identification of maternal and infant surveillance indicators for tracking the health effects of climate change. The proposed research is innovative because results will 1) show how climate and social stressors interact to exacerbate climate-health risks during pregnancy, and 2) aid in hypothesis generation on the pathways that contribute to climate resilience and the reduction of maternal and infant health risks. This work has significant potential to be transformative to the field through the identification of maternal or infant health outcomes as potential surveillance health indicators of climate change impacts, which can be leveraged to measure local and state-level health interventions and policy changes in the United States. Results will address a well-cited research need from the NIH Strategic Climate & Health Initiative on the timing of exposure to climate stressors and associated maternal and infant complications and the critical windows of susceptibility during the prenatal period.

项目概要 气候危机与其他社会和环境压力因素相结合，对 人类健康；其影响因年龄组和生命阶段而异。怀孕是一个尚未充分研究的关键 易感性窗口。很少有研究关注产前暴露于气候压力源对胎儿的影响。 尽管气候变暖趋势明显，但美国东南部的孕妇和婴儿 该地区孕产妇死亡率不断上升，孕产妇和婴儿健康状况持续存在差距。一个重要的 在确定国家气候变化和健康监测指标方面仍然存在科学差距，特别是 了解气候变化与怀孕风险之间的关系。我们的长期目标是发展 基于临床和公共卫生的干预措施，以减少怀孕期间气候变化的不利影响。 这项基于人群的研究的总体目标是检查极端温度敏感性 怀孕关键时期的孕产妇和婴儿健康风险以及对这一问题的进一步了解 气候变化中健康差异的社会环境驱动因素。我们将实现以下两个目标 具体目标： 目标 1. 表征暴露于寒冷和炎热环境温度之间的关系 怀孕关键时期的极端和不利的孕产妇和婴儿健康结果；目标2。 检查产前暴露于极端温度和社会环境压力因素对胎儿的联合影响 母婴健康风险过高。新的 NIH 气候变化与健康战略倡议 面对极端气温，优先保护孕妇的健康。这种低成本 回顾性出生队列研究将加深对社会和环境条件如何影响的理解 怀孕期间发生的疾病与气候变化压力因素相互作用，对孕妇的健康产生负面影响 人口及其婴儿。我们的预期结果将包括：1）产前暴露的量化 气候变化是怀孕期间的风险倍增器； 2）母婴身份识别 追踪气候变化对健康影响的监测指标。所提出的研究具有创新性 因为结果将 1) 显示气候和社会压力因素如何相互作用，从而加剧气候健康风险 怀孕，以及 2) 帮助生成关于有助于气候适应力和气候变化的途径的假设。 减少母婴健康风险。这项工作具有变革性的巨大潜力 通过将孕产妇或婴儿健康结果确定为潜在的监测健康指标 气候变化影响，可用于衡量地方和州一级的健康干预措施 美国的政策变化。结果将满足 NIH 战略研究的广泛引用的研究需求 关于暴露于气候压力因素及相关孕产妇和婴儿的时间的气候与健康倡议 并发症和产前易感性的关键窗口。