Cardiovascular Health After Placental Abruption (CHAP)

胎盘早剥后的心血管健康 (CHAP)

• 批准号: 10238171
• 负责人: Cande V. Ananth
• 金额: $ 68.65万
• 依托单位: RBHS-ROBERT WOOD JOHNSON MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-13 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10238171
• 关键词: Abruptio Placentae; Acute; Acute myocardial infarction; Address; Adult; Affect; Arteries; Attention; Birth; Cardiovascular Diagnostic Techniques; Cardiovascular Diseases; Cardiovascular system; Cerebrovascular Disorders; Cessation of life; Characteristics; Child; Child Health; Chronic Disease; Classification; Clinical; Congestive Heart Failure; Data; Databases; Discipline of obstetrics; Disease; Educational workshop; Ethnic Origin; Etiology; Event; Fetal Death; Fetal Growth Retardation; Frequencies; Future; Gestational Age; Gestational Diabetes; Goals; Health Policy; Hemorrhage; High Risk Woman; Hospitalization; Hospitals; Infant Health; Infant Mortality; Inflammation; Ischemia; Life; Link; Live Birth; Machine Learning; Maternal-Fetal Exchange; Measures; Mediating; Mediation; Medical; Morbidity - disease rate; Myocardial Infarction; Myocardial Ischemia; National Heart, Lung, and Blood Institute; National Institute of Child Health and Human Development; New Jersey; Newborn Infant; Outcome; Oxidative Stress; Patients; Perinatal mortality demographics; Placenta; Pre-Eclampsia; Predisposition; Pregnancy; Premature Birth; Public Health; Pulmonary Embolism; Race; Recommendation; Recurrence; Reporting; Risk; Risk Factors; Rupture; Sentinel; Severities; Small for Gestational Age Infant; Socioeconomic Status; Stimulus; Stroke; System; Twin Multiple Birth; United States National Institutes of Health; Uterus; Vision; Woman; Women' s Health; acute care; base; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; cerebrovascular; comorbidity; data acquisition; deep learning algorithm; epidemiology study; follow-up; health of the mother; high risk; hypertensive heart disease; improved; infant death; insight; interest; maternal cigarette smoking; maternal risk; mortality; obstetrical complication; policy implication; population based; premature; screening guidelines; sociodemographics; stillbirth; support vector machine; thrombotic

Abstract Placental abruption is an obstetrical complication defined as premature placental separation. Despite its elusive etiology, it is believed to be the consequence of acute stimuli – ischemia, inflammation, and oxidative stress at the maternal‐fetal interface – associated with rupture of the decidual artery, resulting in (premature) placental separation. The study of abruption and maternal and newborn long‐term cardiovascular and hemorrhagic/thrombotic cerebrovascular events is the central focus of the proposed project. We will examine the long‐term impact of abruption on rates of cardiovascular and cerebrovascular morbidity and mortality in women and in their children. We will also investigate the relationship of clinical classification (mild and severe forms) of abruption, risks based on abruption across successive pregnancies, and abruption in twin pregnancies, on rates of cardiovascular and cerebrovascular events. We will undertake a causal mediation analysis to evaluate the extent to which these associations may be mediated through (i) preterm delivery and (ii) small for gestational age births. We will perform this analysis by clinical classification of abruption and estimate the extent of mediation following corrections for both measured (socio‐demographic characteristics, including maternal smoking, comorbid medical conditions, and obstetrical events), and unmeasured confounding. A unique aspect of this project will be to identify, through applications of Support Vector Machines and Deep Learning algorithms, subsets of women at high risk for abruption and cardiovascular and cerebrovascular mortality and morbidity. Finally, we will examine whether maternal race/ethnicity and socioeconomic status are effect measure modifiers of the association between abruption and risks of cardiovascular and cerebrovascular events. We propose to address these aims through a large population‐based epidemiologic study, utilizing data from the Myocardial Infarction Data Acquisition System (MIDAS), a New Jersey statewide database of all patients admitted to all non‐federal acute care hospitals in NJ with a CVD diagnosis, with longitudinal follow‐up of up to 30 years. The MIDAS data will be linked to the NJ fetal death and linked live birth‐ infant death data with associated maternal and newborn hospitalization data between 1980‐2017 to create one of the largest and most comprehensive databases in the US to evaluate the extent to which sentinel events in pregnancy impart lasting risk for women's and children's health later in life. This project will provide unprecedented opportunities to address public health, policy implications and clinical screening recommendations of women during the period following delivery regarding risk susceptibility to cardiovascular and cerebrovascular disease.

抽象的 胎盘破裂是一种产科汇编，被定义为预言。 它被认为是母亲 - fetal- fetal的急性刺激，炎症和氧化应激的疾病。 界面 - 与十字内动脉的破裂相关，导致（预先）胎盘分离。 出现，母亲和新生儿长期心血管和出血/血栓性脑血管事件是IS IS IS IS ISTE 拟议项目的主要重点。 妇女及其子女的脑血管发病率和刻度。 临床分类（轻度和严重形式）的破裂，基于连续的前提的突发性和饮食的风险。 双胞胎怀孕的突发事件，关于心血管和脑血管事件的发生率。 调解分析以评估通过（i）早产和 （ii）胎龄小的小。 对两个测量的校正后的调解程度 吸烟，合并医疗状况和产科事件）和独特的ASURED困惑。 通过支持向量机和深度学习算法的应用，可以识别项目 妇女出现高风险，心血管和脑血管死亡率和发病率。 孕产妇种族/种族和社会经济地位是否是介于两者之间的选择 心血管和脑血管事件的破坏和风险。 基于人群的流行病学研究，利用心肌梗塞数据采集系统（ADA）的数据，A 新泽西州全州范围内的所有患者的数据库，他们接受了CVD诊断的所有非联邦急诊医院旅馆， 纵向跟随 - 最多30年。 婴儿数据与1980 - 2017年之间的相关孕妇和新生医院数据相关的数据，以创建其中之一 美国最大，最大的补偿数据库，以评估哨兵事件在怀孕期间的程度 妇女和儿童健康的持续风险在以后的生活中。 公共卫生，政策含义和清洁筛查推荐妇女在交货后的期间推荐接收 关于对心血管和脑血管疾病的风险敏感性。