Project 2: Disparities-Aware Classifiers for Maternal and Infant Health

项目 2：母婴健康差异感知分类器

• 批准号: 10062088
• 负责人: ELAINE SYMANSKI
• 金额: $ 42.91万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-16 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10062088
• 关键词: Affect; African American; Area; Aromatic Polycyclic Hydrocarbons; Awareness; Behavior; Biological; Biological Factors; Blood; Cells; Characteristics; Chemicals; Cities; Clinical; Complex; County; Data; Development; Disasters; Eclampsia; Economics; Enrollment; Environmental Health; Ethnic group; Evaluation; Exposure to; Family; Goals; Hazardous Waste Sites; Health; Home environment; Individual; Industrialization; Infant; Infant Health; Intervention; Maternal Health; Maternal and Child Health; Medicine; Metadata; Metal exposure; Metals; Minority; Morbidity - disease rate; Neighborhoods; Neonatal Mortality; Not Hispanic or Latino; Outcome; Pediatric Hospitals; Personal Satisfaction; Physical environment; Population; Populations at Risk; Postpartum Period; Poverty; Pre-Eclampsia; Pregnancy; Pregnant Women; Premature Birth; Prevalence; RNA; Race; Reproductive History; Research; Research Project Grants; Resources; Rest; Risk; Risk Factors; Second Pregnancy Trimester; Social Environment; Specific qualifier value; Testing; Texas; Third Pregnancy Trimester; Time; Validation; Vulnerable Populations; Woman; Women' s Health; built environment; college; economic cost; health care quality; health disparity; improved; interest; maternal risk; microbiome; model development; mortality risk; neonatal morbidity; obstetric outcomes; pregnancy disorder; pregnancy hypertension; prospective; psychosocial; racial disparity; sociodemographics; socioeconomic disadvantage; stressor

ABSTRACT A woman’s wellbeing during pregnancy affects her short- and long-term health as well as that of her infant. In fact, preterm delivery is a leading indicator of health in the U.S. because of its devastating impacts on neonatal mortality and morbidity with estimated economic costs that exceed 25 billion dollars each year. Despite advances over the last decade in reducing the annual prevalence of preterm birth to under 10%, persistent racial inequities remain that pose significant challenges to improving maternal and child health among health disparity populations in the U.S. Hypertensive disorders of pregnancy (HDP), which consist of eclampsia, preeclampsia and gestational hypertension, affect up to 10% of pregnancies and, like preterm delivery, increase maternal risks of mortality and morbidity that extend far beyond post-partum periods. Significant racial disparities exist, with African-American (AA) women at greatest risk for preterm birth and for dying from HDP than any other racial or ethnic group in the U.S. Traditional risk factors (e.g., maternal sociodemographic characteristics, behaviors, reproductive history and access to quality health care) do not fully explain racial disparities in preterm birth or other obstetric outcomes. To elucidate determinants of these racial disparities, we must consider aspects of the broader biological, physical, social and built environments that may affect women’s health, and move toward an integrated assessment of these factors to more accurately predict risk. Pregnant women in Houston are an at risk population. As a petrochemical hub and fourth largest city in the U.S., Houston is a microcosm for identifying factors of the biological, physical, social, and built environments that constitute the “environmental riskscape”. Defining riskscape features underlying preterm birth and other obstetric outcomes will inform our understanding of determinants of racial disparities in these outcomes in Houston and for disparity populations across the nation. The overall Objective of this Research Project, Disparities-aware Classifiers for Maternal and Infant Health, is to develop “disparities-aware” classifiers that identify major drivers of preterm birth and HDP using an inclusive environmental riskscape framework. To do so, we will conduct a study building upon the unique PeriBank resource at Baylor College of Medicine to acquire data on maternal biological [circulating cell-free RNA (cfRNA) and microbiome] and chemical (PAH and metal) exposures, as well as features of the social and built environments. These data will be used to identify informative features that can be integrated into AA and non- Hispanic white (NHW) disparities-aware classifiers for preterm birth and HDP. Predictive disparities-aware classifiers that rely on attributes of individual- and place-level stressors have the potential for identifying major drivers of preterm birth and HDP among AA and NHW women and provide direction for developing interventions to mitigate disparities and improve the health and well-being of women and their infants.

抽象的 怀孕期间，妇女的健康会影响她的短期和长期健康以及婴儿的健康。 事实，早产是美国健康的主要指标，因为它对新生儿产生了毁灭性的影响 死亡率和发病率和估计的经济成本每年超过250亿美元。尽管 在过去十年中，将早产的年龄降低到10％，持续种族的进步 不平等仍然构成重大挑战，以改善健康差异的孕妇和儿童健康 美国妊娠高血压疾病（HDP），由子痫，先兆子痫组成 和妊娠高血压，影响多达10％的怀孕，并且像早产一样，增加了母子风险 死亡率和发病率远远超出了产后时期。存在重大的种族差异， 非裔美国人（AA）妇女比任何其他种族或 美国传统危险因素（例如，母体社会人口统计学特征，行为， 生殖历史和获得优质医疗保健的机会）不要完全解释早产或 其他产科结果。为了阐明决定这些种族差异，我们必须考虑 更广泛的生物学，物理，社会和建筑环境可能会影响妇女的健康，并朝着一个 对这些因素的综合评估以更准确地预测风险。休斯顿的孕妇是 风险人口。休斯敦是美国的石化枢纽和四个最大的城市，是识别的缩影 构成“环境风险景观”的生物，物理，社会和建筑环境的因素。 定义早产和其他产科结果的风险景观特征将告知我们的理解 确定休斯顿这些结果中的种族差异以及全国各地的差异人群。 该研究项目的总体目标是孕产妇和婴儿健康的差异分类器， 是开发“意识到差异”的分类器，这些分类器使用包容性识别早产和HDP的主要驱动力 环境风险景观框架。为此，我们将在独特的Peribank上进行研究 贝勒医学院的资源以获取有关母体生物学的数据[无细胞RNA（CFRNA） 和微生物组]和化学（PAH和金属）的暴露，以及社交和建造的特征 环境。这些数据将用于确定可以集成到AA和非 - 西班牙裔白色（NHW）差异 - 意识到早产和HDP的分类器。预测差异会意识到 依靠个人和地点压力源属性的分类器具有识别主要的分类器 AA和NHW妇女中早产和HDP的驱动因素，并为制定干预措施提供了指导 减轻差异并改善妇女及其婴儿的健康和福祉。