Pregnancy and perinatal complications and mortality: Collaborative Perinatal Project mortality linkage study

妊娠和围产期并发症和死亡率：协作围产期项目死亡率关联研究

• 批准号: 10684579
• 负责人: Edwina Yeung
• 金额: $ 9.04万
• 依托单位: EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10684579
• 关键词: 7 year old; Address; African American population; Archives; Asian; Behavior; Birth; Blood specimen; Cardiovascular Diseases; Cause of Death; Cessation of life; Characteristics; Child; Data; Enrollment; Epidemiology; European; Event; Gestational Diabetes; Goals; Gravid; Health; Hispanic; Hormones; Interview; Kidney Diseases; Link; Malignant Neoplasms; Maternal Mortality; Maternal Physiology; Medical History; Metabolism; Microfilm; Participant; Perinatal; Perinatal mortality demographics; Population; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy loss; Premature Birth; Prospective, cohort study; Race; Records; Research; Series; Socioeconomic Status; Stress; Universities; Woman; cardiovascular disorder risk; clinical center; demographics; disorder risk; follow-up; health record; hemodynamics; insight; mortality; neonatal outcome; novel; perinatal complications; pregnancy health; success

o Pregnancy is a common event that imposes significant stresses on maternal physiology, with substantive changes in metabolism, hemodynamics, and hormone levels that can expose underlying disease risks for women. While studies linking pregnancy events to mortality have been feasible using nationally linked health records in European nations, such linkages are less common in the US. Detailed pregnancy records with the ability to be linked to the NDI, which provides valuable cause of death information, were previously lacking. This presents a major data gap, as the US population has a different race/ethnic make-up, in particular African Americans who are known to have an increased risk for cardiovascular diseases and earlier death compared to whites. To address this gap, the CPP Mortality Linkage Study linked women who participated in the CPP with the NDI. The CPP was a prospective cohort study of 48,197 women with 55,908 pregnancies and 54,390 births at 12 university clinical centers across the US from 1959-1965. Detailed information on demographics, medical history, socioeconomic status, and behavior were collected via interviews at enrollment. Physical exams were performed, and blood samples collected throughout pregnancy. Children were followed to age 7 years. Approximately 46.2% of the enrolled women were white, 46.0% were black, 6.8% were Hispanic, and 1% of Asian or other descent. Progress Personal identifying data was successfully abstracted on 46,428 (97%) CPP participants from the original participant records archived in microfiche. The linkage with the NDI was completed in 2017. Using the NDI, a total of 35% of participants were identified as deceased as of 2016, which was consistent with an expected mortality of 39%. Initial analyses demonstrated the success of the linkage (Pollack and Hinkle et al. Epidemiology 2020), which opens doors to a series of research on lifelong health implications of pregnancy conditions. The successful linkage of the Collaborative Perinatal Project with mortality records offers a unique opportunity for insight on associations between gravid conditions and the longest follow up of mortality for U.S. women. Novel findings were identified, and multiple projects are ongoing to investigate long-term health implications of pregnancy health conditions by linking pregnancy health and events (e.g., gestational diabetes, preeclampsia, preterm birth, pregnancy loss, placental characteristics) to causes of maternal death 50+ years later (e.g., cardiovascular disease, cancer, and renal diseases).

o怀孕是一个常见的事件，对孕产妇生理施加重大压力，代谢，血液动力学和激素水平发生实质性变化，可以暴露女性的潜在疾病风险。尽管使用欧洲国家的全国性健康记录将怀孕事件与死亡率联系起来的研究是可行的，但在美国，这种联系不太常见。详细的怀孕记录具有与NDI相关的能力，该记录以前缺乏了有价值的死亡信息。这有一个重大的数据差距，因为美国人口具有不同的种族/族裔化妆，特别是非洲裔美国人，他们的心血管疾病风险增加了，与白人相比，他们患有心血管疾病的风险增加。为了解决这一差距，CPP死亡率链接研究将与NDI一起参加CPP的妇女联系在一起。 CPP是一项前瞻性队列研究，对1959 - 1965年美国12个大学临床中心的48,197名妇女有55,908例怀孕和54,390个出生。有关人口统计学，病史，社会经济状况和行为的详细信息是通过入学式访谈收集的。进行体格检查，并在整个怀孕期间收集血液样本。儿童遵循7岁。约有46.2％的入学妇女是白人，46.0％为黑色，6.8％为西班牙裔，其中1％的亚洲或其他血统。 进度的个人身份数据在46,428（97％）的CPP参与者中成功提取了来自微叶片的原始参与者记录的参与者。与NDI的联系于2017年完成。使用NDI，总共35％的参与者被确定为2016年已故，这与预期死亡率为39％一致。最初的分析表明了连锁的成功（Pollack和Hinkle等，流行病学2020），这为妊娠条件的终身健康影响开辟了一系列研究。该协作围产期项目与死亡率记录的成功联系为洞悉妊娠条件与美国妇女死亡率最长的随访提供了独特的机会。确定了新的发现，并正在进行多个项目，以研究怀孕健康和事件的长期健康状况的长期健康影响（例如，妊娠糖尿病，前偏见，早产，早产，妊娠丧失，胎盘特征）与50多年以上的孕产妇死亡的原因（例如，50多年以后）