Hypertensive Disorders of Pregnancy and Early Risk of Maternal CVD: Influence of the External Exposome

妊娠期高血压疾病和孕产妇心血管疾病的早期风险：外部暴露的影响

• 批准号: 10645046
• 负责人: Hui Hu
• 金额: $ 15.88万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10645046
• 关键词: Accounting; Address; Area; Aspirin; Award; Big Data; Biological Markers; Birth Records; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Clinical; Clinical Research; Data; Data Science; Data Scientist; Development; Dose; Eclampsia; Electronic Health Record; Environment; Environmental Epidemiology; Environmental Exposure; Environmental Impact; Environmental Risk Factor; Epidemiologist; Five-Year Plans; Florida; Funding; Goals; High Risk Woman; Hypertension; Incidence; Knowledge; Leadership; Learning; Link; Measurement; Mediation; Mentorship; Modeling; Outcome; Pathogenicity; Perinatal; Perinatal Epidemiology; Play; Postpartum Period; Postpartum Women; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnant Women; Prevention; Productivity; Publications; Recording of previous events; Records; Research; Research Personnel; Research Project Grants; Residential Mobility; Risk; Risk Assessment; Risk Factors; Role; Severities; Source; Techniques; Testing; Training; Training Programs; Vital Statistics; Woman; Work; biomedical informatics; cardiovascular disorder risk; cardiovascular health; career; career development; data resource; deep learning model; design; digital repositories; experience; fetal; health data; individualized prevention; infant morbidity/mortality; informal learning; insight; maternal morbidity; maternal risk; modifiable risk; mortality; novel; post pregnancy; predictive modeling; pregnancy disorder; pregnancy hypertension; prevent; programs; skills; sociodemographics

PROJECT SUMMARY Hypertensive disorders of pregnancy (HDP) are the most common pregnancy complication and are associated with an increased long-term risk of cardiovascular disease (CVD) which is also the leading cause of death for women in the US. Emerging evidence suggests that environmental exposure during pregnancy may play an important role in the development of HDP. However, several limitations exist, including 1) the ignorance of residential mobility during pregnancy in exposure assessments, 2) the lack of studies considering different subtype, onset, and severity of HDP, and 3) the lack of considerations of the totality of environment (i.e. the exposome). While HDP have been linked to long-term CVD risk after pregnancy, limited data are available on early maternal CVD risk (within the first five years after delivery) complicated by HDP. More importantly, no study has focused on the impact of environmental exposures during and after pregnancy on maternal CVD risk after pregnancy. In addition, risk assessment models of HDP predominantly rely on biomarkers that are not ubiquitously tested among all pregnant women, and no predictive model has been developed to identify women at higher CVD risk after pregnancy. This study builds on our prior work in the external exposome and leverages our access to the unique statewide linked electronic health records-birth records data from the OneFlorida Clinical Research Consortium to address multiple challenges in the field by: 1) determining the association between pregnancy external exposome and risk of HDP, considering the subtype, onset, and severity of HDP and accounting for pregnancy residential mobility in exposure measurements; 2) assessing early risk of maternal CVD after pregnancy associated with HDP and the external exposome, and 3) developing predictive models of HDP and early risk of maternal CVD after pregnancy. This research project will be embedded in a comprehensive training program consisting of coursework, guided experiential and clinical learning, seminars, and mentorship by an established team of experts. The training program is designed to further my strengths and to develop new research skills while contributing to our scientific understanding of environmental impacts on cardiovascular health among pregnant and postpartum women. The training proposal details a five-year plan of formal and informal instruction in cardiovascular health, omics and exposome research, biomedical informatics and data science, and professional skills. My short-term career goals include completing coursework in all training areas, disseminating study findings through publications and presentations, engaging in career development activities, and applying for independent R01 funding in the third year of the award. My long-term career goal is to become an independent, collaborative, and productive epidemiologist and health data scientist leading research programs in cardiovascular health, with a focus on its intersection with perinatal and environmental epidemiology using big data.

项目概要 妊娠期高血压疾病 (HDP) 是最常见的妊娠并发症，与 心血管疾病（CVD）的长期风险增加，这也是导致死亡的主要原因 美国的女性。新的证据表明，怀孕期间的环境暴露可能会产生影响 在HDP的发展中发挥着重要作用。然而，存在一些局限性，包括 1) 对 暴露评估中孕期居住流动性的影响，2）缺乏考虑不同因素的研究 HDP 的亚型、发病情况和严重程度，以及 3) 缺乏对环境整体的考虑（即 暴露组）。虽然 HDP 与怀孕后的长期 CVD 风险有关，但可用的数据有限 早期孕产妇 CVD 风险（产后五年内）并发 HDP。更重要的是，没有 研究重点是怀孕期间和怀孕后环境暴露对孕产妇心血管疾病风险的影响 怀孕后。此外，HDP 的风险评估模型主要依赖于非生物标志物。 在所有孕妇中进行了普遍测试，并且尚未开发出预测模型来识别 怀孕后心血管疾病风险较高的女性。这项研究建立在我们之前的外部暴露研究工作的基础上 利用我们对全州范围内唯一链接的电子健康记录-出生记录数据的访问 OneFlorida 临床研究联盟通过以下方式解决该领域的多重挑战：1) 确定 考虑到亚型、发病情况和 HDP 风险，妊娠期外部暴露与 HDP 风险之​​间的关联 HDP 的严重程度以及暴露测量中妊娠期居住流动性的考虑； 2）评估 妊娠后母体 CVD 的早期风险与 HDP 和外部暴露相关，3) 开发 HDP 和妊娠后母亲 CVD 早期风险的预测模型。该研究项目将 纳入由课程作业、指导性体验和临床组成的综合培训计划 由已建立的专家团队提供学习、研讨会和指导。该培训计划旨在 进一步增强我的优势并发展新的研究技能，同时为我们对科学的理解做出贡献 环境对孕妇和产后妇女心血管健康的影响。培训内容 该提案详细介绍了心血管健康、组学和心血管健康方面的正式和非正式指导的五年计划 暴露组研究、生物医学信息学和数据科学以及专业技能。我的短期职业生涯 目标包括完成所有培训领域的课程作业，通过出版物传播研究结果 和演讲，参与职业发展活动，并申请独立的 R01 资助 获奖的第三年。我的长期职业目标是成为一名独立、协作、高效的人 流行病学家和健康数据科学家领导心血管健康研究项目，重点关注其 使用大数据与围产期和环境流行病学交叉。