Impact of the COVID-19 pandemic, SARS-CoV-2 infection and social determinants of health on pregnancy complications, birth outcomes and post-pregnancy maternal cardiovascular and mortality outcomes Div

COVID-19 大流行、SARS-CoV-2 感染和健康社会决定因素对妊娠并发症、出生结局以及孕后孕产妇心血管和死亡率结果的影响 Div

• 批准号: 10732644
• 负责人: KELLY J HUNT
• 金额: $ 6.87万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10732644
• 关键词: 2019-nCoV; Address; Admission activity; African American; Award; Birth; Black race; COVID-19; COVID-19 diagnosis; COVID-19 pandemic; COVID-19 pandemic effects; COVID-19 test; Cardiovascular Diseases; Cardiovascular system; Caring; Censuses; Clinic; Coronary heart disease; Data; Data Set; Diabetes Mellitus; Disparity; Economics; Embolism; Emergency department visit; Ethnic Origin; Event; Extracorporeal Membrane Oxygenation; Functional disorder; Funding; Health; Health Policy; Healthcare; Hispanic; Hospitalization; Hypertension; Incidence; Infant; Infant Mortality; Infection; Intensive Care Units; Interruption; Job loss; Left; Link; Live Birth; Longitudinal cohort; Maternal Mortality; Measures; Mechanical ventilation; Medicaid; Medical; Minority Groups; Morbidity - disease rate; Mothers; Myocardial Infarction; Obesity; Outcome; Parents; Population; Population Study; Populations at Risk; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnant Women; Premature Birth; Prevalence; Prevention; Public Health; Race; Records; Reporting; Risk; Risk Factors; SARS-CoV-2 infection; SARS-CoV-2 positive; Small for Gestational Age Infant; Social Distance; Social Work; South Carolina; Stroke; Testing; Time Series Analysis; Transportation; United States; Vascular Diseases; Ventricular; Virus; Woman; Women' s Health; adverse birth outcomes; cardiovascular risk factor; clinical care; clinical practice; cohort; comorbidity; coronavirus pandemic; ethnic difference; ethnic disparity; follow-up; health care availability; health care service; health difference; health disparity; health inequalities; human old age (65+); improved; indexing; infant morbidity; infant morbidity/mortality; infant outcome; maternal diabetes; maternal morbidity; maternal obesity; maternal outcome; maternal risk; mortality; novel; outcome disparities; pandemic coronavirus; pandemic disease; parent grant; population based; post pregnancy; pre-pandemic; pregnant; prepregnancy; prepregnancy obesity; racial difference; racial disparity; severe maternal morbidity; social; social determinants; social disparities; social health determinants; social vulnerability; ventilation

PROJECT SUMMARY OF PARENT GRANT: Nationally, South Carolina (SC) ranks among the worst for poor pregnancy outcomes and high maternal and infant mortality rates, with vast racial/ethnic disparities present. Infection with the novel SARS-CoV-2 during pregnancy has been associated with pregnancy complications and poor infant and maternal outcomes including mortality. Moreover, the effect of social determinants and inequities in healthcare received and health outcomes have been heightened by the COVID-19 pandemic caused by SARS-CoV-2. Cardiovascular risk factors during pregnancy (e.g., obesity, diabetes, and hypertension) and pregnancy complications such as pre-eclampsia are common, can result in morbidity and mortality for the mother and the baby, and are well-known risk factors for maternal cardiovascular and vascular disease short and long-term. Infection with SARS-CoV-2 during pregnancy has also been related to complications (e.g., intensive care unit (ICU) admission, invasive ventilation, myocardial infarction, embolism). Less information is available regarding the impact of the COVID-19 pandemic or specifically SARS-CoV-2 infection on maternal and infant morbidity and mortality. The objective of our study is to understand the impact of both the COVID-19 pandemic and infection with SARS-CoV-2 on the risk of maternal and infant morbidity and mortality including pregnancy complications (e.g., pre-eclampsia, ICU admissions, mechanical ventilation), adverse birth outcomes (e.g., preterm birth, small for gestational age), and maternal cardiovascular events (e.g., coronary heart disease, stroke, embolism) during and post-pregnancy. Data from statewide administrative datasets (e.g., hospitalizations, vital records, Medicaid, positive COVID-19 tests) will be linked to create a diverse, longitudinal cohort of women who gave birth between 2018-2021 with at least one year of follow-up through 2022. Approximately 45,000 live birth pregnancies take place in SC each year for a total of ~180,000 deliveries anticipated over the 4-year study period. As of June 1, 2021, 2600 pregnant women in SC were diagnosed with COVID-19. The proposed project aims to evaluate the impact of the COVID-19 pandemic (Aim 1) and the impact of SARS-CoV-2 infection (Aim 2) at the population level in SC on (1) pregnancy complications, adverse birth outcomes, maternal cardiovascular events, and maternal and infant mortality; (2) maternal one-year post pregnancy cardiovascular and mortality outcomes; and (3) to examine differences by race/ethnicity, social vulnerability, distance to main medical facility, and pre-pregnancy obesity and diabetes. This study will be among the first to evaluate the COVID-19 pandemic and SARS-CoV-2 infection during pregnancy in relation to maternal and infant morbidity and mortality in a population-based study. Determining the impact of the COVID-19 pandemic and SARS-CoV-2 infection on infant and maternal morbidity and mortality and the extent of social and racial-ethnic differences is critical to improving pregnancy outcomes and health disparities in the U.S. Findings are expected to inform clinical care of pregnant women and public health policy.

父母赠款的项目摘要： 在全国范围内，南卡罗来纳州（SC）是妊娠不良结局和高母亲和高母亲和 婴儿死亡率，存在巨大的种族/种族差异。在新颖的SARS-COV-2感染期间 怀孕与怀孕并发症和婴儿不良和孕产妇结局有关 死亡。此外，社会决定因素和不平等的医疗保健和健康成果的影响 由SARS-COV-2引起的COVID-19大流行已经增强。心血管危险因素 怀孕（例如肥胖，糖尿病和高血压）和妊娠并发症，例如子痫前期是 常见，可能导致母亲和婴儿的发病率和死亡率，并且是众所周知的风险因素 孕产妇心血管和血管疾病短期和长期。怀孕期间用SARS-COV-2感染 也与并发症有关（例如，重症监护病房（ICU）入院，侵入性通风，心肌 梗塞，栓塞）。关于COVID-19大流行或 特别是SARS-COV-2感染了母体和婴儿的发病率和死亡率。我们研究的目的是 了解COVID-19大流行和SARS-COV-2感染对母亲的风险的影响 婴儿的发病率和死亡率在内，包括妊娠并发症（例如，前宾夕化，ICU入院， 机械通气），不良出生结果（例如，早产，胎龄小）和母亲 心血管事件（例如冠状动脉疾病，中风，栓塞）和怀孕后。来自 全州行政数据集（例如，住院，重要记录，医疗补助，阳性Covid-19测试）是 与创建各种各样的纵向女性有关的女性，她们在2018 - 2021年之间生育至少一个 到2022年的随访年。每年在SC发生大约45,000例现场出生怀孕 在4年的研究期间，预计总计约有18万次交付。截至2021年6月1日，2600名孕妇 在SC中，被诊断为COVID-19。拟议的项目旨在评估Covid-19的影响 大流行（AIM 1）和SARS-COV-2感染（AIM 2）对SC中的人口水平的影响（1）怀孕 并发症，不良出生结果，母体心血管事件以及母亲和婴儿死亡率； （2） 孕妇怀孕后心血管和死亡率成果； （3）通过 种族/种族，社会脆弱性，与主要医疗设施的距离以及孕前肥胖和糖尿病。 这项研究将是最早评估COVID-19的大流行和SARS-COV-2感染的研究之一 在基于人群的研究中，与母亲和婴儿的发病率和死亡率有关的怀孕。确定 COVID-19大流行和SARS-COV-2感染对婴儿的影响以及孕产妇的发病率和死亡率 社会和种族差异的程度对于改善妊娠结局和健康至关重要 预计美国的发现将为孕妇和公共卫生政策提供临床护理。