The Role of Hypothalamic Pituitary - Adrenal Axis Dysregulation in Preterm Birth

下丘脑垂体-肾上腺轴失调在早产中的作用

基本信息

批准号：
10038515
负责人：
Bizu Gelaye
金额：
$ 25.81万
依托单位：
HARVARD SCHOOL OF PUBLIC HEALTH
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-08-24 至 2022-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10038515
关键词：
Address Adrenal Glands Adult Affect Anxiety Disorders Behavior Disorders Biological Markers Birth Child Abuse and Neglect Childhood Chronic Chronic stress Clinical Complex Data Data Analyses Developing Countries Development Epidemiology Exposure to Female of child bearing age Forcible intercourse Funding Generations Goals Hair Health Hispanics Hour Hydrocortisone Hypothalamic structure Individual Infant Infant Mortality Intervention Intervention Studies Investigation Knowledge Life Life Cycle Stages Link Literature Low Birth Weight Infant Low income Measurement Measures Mediation Mental Health Mental disorders Modeling Monitor Mood Disorders Morbidity - disease rate National Institute of Child Health and Human Development Neurobiology Outcome Perinatal Peru Pituitary Gland Plasma Population Pregnancy Pregnancy Complications Pregnant Women Premature Birth Problem behavior Psychological Stress Psychopathology Public Health Recording of previous events Research Research Design Risk Risk Factors Role Saliva Sampling Scalp structure Series Severities Sexual abuse Sleep Disorders System Testing Time Trauma United States United States National Institutes of Health Vision Vulnerable Populations Woman Work adverse pregnancy outcome behavioral pharmacology cardiometabolism cohort cost effective design early childhood early life adversity effective intervention emerging adult experience fetal loss global health hypothalamic-pituitary-adrenal axis intimate partner violence men mood symptom novel obstetrical syndromes offspring perinatal health perinatal outcomes physical abuse physical conditioning population health prospective secondary analysis stressor therapy design trauma exposure traumatic event

项目摘要

PROJECT SUMMARY/ABSTRACT Preterm birth (PTB) continues to be one of the leading causes of infant mortality, pediatric morbidity, and a major public health problem. PTB, now recognized as a global obstetrical syndrome, occurs due to a complex cluster of problems with a set of overlapping risk factors and influences including exposure to traumatic events. A major challenge in past studies of trauma experiences and PTB has been a lack of reliable biomarkers for individuals’ exposure to psychological stress, particularly chronic stress. Several studies in men and non- pregnant women have shown alterations in the hypothalamic–pituitary–adrenal (HPA) axis in individuals with a history of trauma. Emerging data, including our own, provides compelling evidence on the relationship between maternal trauma experiences and adverse pregnancy outcomes such as PTB. However, to date, the role of HPA axis dysregulation in pregnant women with a history of trauma and potential links to PTB has not been systematically evaluated. We will conduct this secondary analysis of data and samples from a cohort of 2,700 pregnant women in Lima, Peru. The proposed project will be the first investigation to assess the hypothesized association between time-integrated measures of cortisol secretion (using scalp hair cortisol concentrations [HCC]) and PTB in a large cohort of pregnant women. Of note, the proposed study leverages one of the few cohorts with prospectively collected hair samples among low-income Hispanic women in Lima, Peru – a population highly exposed to trauma and mental health disorders (R01 HD059835). If results from our cost- effective study indicate a role of HPA dysregulation, the results will contribute to the design of mechanistic studies, as well as the design of intervention studies aimed at reducing the impact of early life adversities and other risk factors of adverse perinatal outcomes in vulnerable populations. Findings from our study will illuminate the role of HPA axis dysregulation in pregnancy which is important to understanding the etiopathogenesis of pregnancy complications such as PTB.

项目概要/摘要早产 (PTB) 仍然是婴儿死亡、儿科发病率和死亡率的主要原因之一 PTB 现已被认为是一种全球性产科综合征，其发生是由于复杂的原因。具有一系列重叠的风险因素和影响（包括遭受创伤事件）的一系列问题。过去对创伤经历和 PTB 研究的一个主要挑战是缺乏可靠的生物标志物个人遭受心理压力，特别是慢性压力的几项研究。孕妇的下丘脑-垂体-肾上腺（HPA）轴已显示出患有以下疾病的个体的改变：新出现的数据，包括我们自己的数据，为两者之间的关系提供了令人信服的证据。然而，迄今为止，产妇创伤经历和不良妊娠结局的作用。尚未发现有创伤史的孕妇的 HPA 轴失调以及与 PTB 的潜在联系我们将对 2,700 名队列的数据和样本进行二次分析。秘鲁利马的孕妇拟议的项目将是第一个评估被捕获者的调查。皮质醇分泌的时间积分测量值之间的关联（使用头皮皮质醇浓度） [HCC]）和 PTB 在一大群孕妇中的应用值得注意的是，拟议的研究利用了少数几个之一。在秘鲁利马的低收入西班牙裔女性中前瞻性收集头发样本的队列—— 高度暴露于创伤和精神健康障碍的人群（R01 HD059835）如果结果是我们的成本- 有效的研究表明 HPA 失调的作用，结果将有助于机制的设计研究以及旨在减少早年逆境影响的干预研究的设计我们的研究结果将影响弱势群体围产期不良结局的其他风险因素。阐明 HPA 轴失调在妊娠中的作用，这对于理解妊娠并发症（如 PTB）的发病机制。