Project 1: The Environmental Riskscape, Disasters and Obstetric Outcomes

项目 1：环境风险状况、灾害和产科结果

• 批准号: 10062087
• 负责人: Hamisu Salihu
• 金额: $ 32.8万
• 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/10062087
• 关键词: Address; African American; Anthracenes; Area; Aromatic Polycyclic Hydrocarbons; Benzo(a)pyrene; Biological; Birth; Case-Control Studies; Chemical Exposure; Chemicals; Child; Color; Communities; Complex; Computerized Medical Record; Data; Development; Disasters; Environment; Environmental Health; Epidemiology; Event; Exposure to; Family; Floods; Fluorine; Foundations; Future; Genetic; Goals; Hazardous Waste Sites; Health; Healthcare; Hurricane; Individual; Industry; Inequality; Infant; Infant Health; Maternal Exposure; Maternal Health; Maternal and Child Health; Medicine; Metal exposure; Metals; Morbidity - disease rate; Mothers; Natural Disasters; Neighborhoods; Not Hispanic or Latino; Outcome; Outcomes Research; Perinatal; Personal Satisfaction; Physical environment; Placenta; Play; Population; Population Heterogeneity; Poverty; Predisposition; Pregnancy; Pregnant Women; Premature Birth; Preventive Intervention; Questionnaires; Research; Research Project Grants; Rest; Risk; Role; Sampling; Social Environment; Source; Statistical Methods; Term Birth; Texas; Woman; Work; base; biobank; black/white disparity; built environment; chemical association; college; data warehouse; design; disorder risk; economic cost; experience; health disparity; improved; low socioeconomic status; mortality; obstetric outcomes; pollutant; racial disparity; response; societal costs; stressor; successful intervention; superfund site

Despite advances in health care, African-Americans (AA) continue to experience a disproportionate burden of poor obstetric outcomes. This is alarming as pregnancy is a window of future health and many obstetric outcomes, such as preterm birth, are associated with severe morbidity and mortality for both the mother and her infant and result in high societal and economic costs. Unfortunately, the origin of racial disparities in obstetric outcomes does not appear to be genetic nor fully explained by individual-level factors; thus, we must look toward the broader context in the physical, built, and social environments to mitigate racial disparities in maternal health. Because communities of color and low socioeconomic status experience a higher burden of chemical exposures, in part due to the proximity of their neighborhoods to key exposure sources (e.g., industry and hazardous waste sites), ‘environment’ has been hypothesized to be a driver of racial disparities in obstetric outcomes. Two classes of pollutants with historic contamination in Houston, TX are polycyclic aromatic hydrocarbons (PAHs) and metals, which have each been positively associated with preterm birth. Additionally, under an environmental riskscape framework, place-based stressors may also contribute to racial disparities in maternal health by directly influencing disease risk and by modifying women’s susceptibility to chemical exposures. Enhanced understanding of the role of the riskscape, and mixtures of chemical and non-chemical stressors, in racial disparities in obstetric outcomes would promote efforts to design successful interventions and improve the wellbeing of health disparity populations. Finally, Houston is a disaster-prone area, which may result in increased exposures to chemical, biological and non-chemical stressors that may be heightened among health disparity populations. Our goal is to mitigate maternal and infant health disparities in an overburdened population living in a disaster-prone region. To achieve this goal, the Objective of this Research Project, The Environmental Riskscape, Disasters and Obstetric Outcomes, is to utilize a large-scale perinatal biobank and data repository (PeriBank) at Baylor College of Medicine to characterize racial disparities in the riskscape of AA and non- Hispanic white (NHW) pregnant women in Houston, to assess associations between the mixture of chemical and non-chemical stressors in the riskscape on preterm birth, and explore the impact of a natural disaster of unprecedented magnitude (Hurricane Harvey) on racial disparities in chemical exposures. Through the application of a riskscape-based approach paired with statistical methods to address mixture effects, the results from this study will enhance our understanding of the roles of chemical and non-chemical stressors in racial disparities in preterm birth in a disaster-prone region. This work will lay the foundation for future studies to improve our understanding of drivers of black-white disparities in obstetric outcomes, research that is imperative for the development and successful implementation of preventive interventions to mitigate these disparities.

尽管医疗保健取得了进步，非裔美国人 (AA) 仍然承受着不成比例的负担 不良的产科结果令人担忧，因为怀孕是未来健康的一个窗口，而且许多产科疾病。 早产等结果与母亲及其母亲的严重发病率和死亡率有关 不幸的是，产科种族差异的根源。 结果似乎不是遗传的，也不是由个体因素完全解释的，因此，我们必须关注； 更广泛的自然、建筑和社会环境，以减少孕产妇健康方面的种族差异。 由于有色人种和社会经济地位较低的社区承受着更高的化学品暴露负担， 部分原因是他们的社区靠近主要暴露源（例如工业和危险废物） 网站），“环境”已被率先视为产科结果种族差异的驱动因素。 德克萨斯州休斯顿历史性污染的污染物包括多环芳烃 (PAH) 和金属， 在环境风险背景下，这些因素都与早产呈正相关。 根据框架，基于地点的压力源也可能直接导致孕产妇健康方面的种族差异 疾病风险并改变女性对化学物质暴露的敏感性。 了解风险景观以及化学和非化学压力源的混合在种族中的作用 产科结果的差异将促进设计成功干预措施并改善产科结果的努力 最后，休斯顿是一个灾害多发地区，这可能会导致人口的健康差距增加。 接触可能导致哮喘的化学、生物和非化学压力源的健康差异 我们的目标是减少生活在负担过重的人口中的孕产妇和婴儿健康差异。 为了实现这一目标，该研究项目的目标是环境。 风险景观、灾害和产科结果将利用大型围产期生物库和数据存储库 贝勒医学院 (PeriBank) 描述了 AA 和非 AA 风险景观中的种族差异 休斯顿的西班牙裔白人 (NHW) 孕妇，评估化学物质混合物与 早产风险景观中的非化学压力源，并探讨自然灾害的影响 化学品暴露方面的种族差异史无前例（飓风哈维）。 应用基于风险景观的方法结合统计方法来解决混合效应，结果 这项研究将加深我们对化学和非化学压力源在种族问题中的作用的理解 这项工作将为未来的研究奠定基础。 提高我们对产科结果中黑人与白人差异的驱动因素的理解，研究势在必行 制定并成功减少这些差异的预防性干预措施。