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.

项目摘要/摘要早产（PTB）仍然是婴儿死亡率，小儿发病率和A的主要原因之一主要的公共卫生问题。 PTB现在被认为是一种全球产科综合症，是由于复杂而发生的一系列重叠的风险因素和影响，包括暴露于创伤事件的问题。过去对创伤经历和PTB的研究的主要挑战是缺乏可靠的生物标志物来个人承受心理压力，尤其是慢性压力。关于男性和非 - 孕妇显示出患有A的个体的下丘脑 - 垂体 - 肾上腺（HPA）轴创伤史。新兴数据（包括我们自己的数据）提供了有关关系的令人信服的证据孕产妇创伤经历和不良怀孕结果，例如PTB。但是，迄今为止，具有创伤病史且潜在与PTB的孕妇的HPA轴失调尚未系统评估。我们将对来自2700的同类的数据和样品进行次要分析秘鲁利马的孕妇。拟议的项目将是评估假设的第一个投资时间整合皮质醇分泌的措施之间的关联（使用头皮头发皮质醇浓度 [HCC]）和PTB在大量孕妇中。值得注意的是，拟议的研究利用了少数秘鲁利马低收入西班牙裔妇女的前瞻性收集的头发样品的同伴 - 人口高度暴露于创伤和心理健康障碍（R01 HD059835）。如果我们的成本结果有效的研究表明HPA失调的作用，结果将有助于机械设计研究以及干预研究的设计旨在减少早期逆境和脆弱人群中不良围产期结果的其他风险因素。我们的研究结果将阐明HPA轴失调在怀孕中的作用，这对于理解妊娠并发症（例如PTB）的疗法发生。