Environmental chemical exposures during pregnancy and women's cardio-metabolic health

怀孕期间的环境化学物质暴露与女性心脏代谢健康

• 批准号: 10247812
• 负责人: Dana Dabelea
• 金额: $ 43.6万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10247812
• 关键词: Address; Adult; Affect; Air; Air Pollutants; Attention; Behavior; Behavioral; Birth; Body Composition; Body Weight; Body mass index; Breast Feeding; Cardiometabolic Disease; Cardiovascular Diseases; Characteristics; Chemical Exposure; Child; Child Health; Chronic Disease; Cohort Studies; Collaborations; Data; Data Collection; Diabetes Mellitus; Diet; Enrollment; Environment; Environmental Exposure; Environmental Impact; Evaluation; Event; Exposure to; Fatty Liver; Fatty acid glycerol esters; Flame Retardants; Funding; Gestational Diabetes; Glucose; Health; Hepatic; Infant Health; Joints; Life; Life Cycle Stages; Link; Liver diseases; Longevity; Longitudinal Studies; Magnetic Resonance Imaging; Maternal Health; Measurement; Medical Records; Metabolic; Metal exposure; Metals; Modeling; Morbidity - disease rate; Mothers; National Institute of Environmental Health Sciences; OGTT; Obesity; Organophosphates; Outcome; Parabens; Participant; Persons; Phenols; Plethysmography; Population; Postpartum Period; Pre-Eclampsia; Pregnancy; Pregnancy Outcome; Pregnant Women; Records; Research; Research Personnel; Risk; Risk Factors; Role; Serum; Statistical Methods; Sturnus vulgaris; Time; Unhealthy Diet; Visit; Weight; Weight Gain; Woman; Women' s Group; Women' s Health; ambient air pollution; behavioral phenotyping; cardiometabolism; cardiovascular disorder risk; cohort; diabetes risk; disorder risk; environmental chemical; environmental chemical exposure; ethnic diversity; experience; follow-up; gestational weight gain; improved; lipid metabolism; maternal outcome; mortality; novel; obesity risk; offspring; phenotypic data; phthalates; pollutant; postpartum weight; pregnancy hypertension; prevent; public health intervention; recruit; residence; urinary

Project Summary While much research has been devoted to exploring the impact of environmental chemical exposures during pregnancy on infant and child health, relatively little attention has focused on the potential influence of these exposures on maternal health. Recent evidence suggests that pregnancy may be a sensitive period in the life course, during which chemical exposures may have long-lasting effects on cardio-metabolic disease risk among women. Using a well-characterized existing cohort study that enrolled 1,410 pregnant women in 2009- 2014, we propose the following aims: (1) quantify the relationship between environmental exposures during pregnancy and short-term maternal health outcomes including: postpartum weight retention, reduced breastfeeding initiation and duration, and incident diabetes; (2) quantify the relationship between environmental exposures during pregnancy and long-term maternal health outcomes: body composition, weight trajectories from pregnancy through ~10 years after parturition, hepatic fat, dysglycemia and incident diabetes, and cardiovascular disease; and (3) evaluate the potential role of maternal characteristics and behaviors during pregnancy, specifically obesity and diet quality, in modifying associations between environmental chemical exposures and outcomes. Exposures during pregnancy will include serum per- and polyfluoroalkyl substances (PFAS), urinary phthalate metabolites, phenols and parabens, metals, organophosphate flame retardants, and modeled air pollutants at the maternal residential address during pregnancy. We propose to recruit 700 of the original study participants to return for a follow-up visit at ~10 years postpartum. At this visit, participants will undergo a comprehensive metabolic health evaluation including body composition via air displacement plethysmography (BOD POD), dysglycemia via oral glucose tolerance test, and hepatic fat fraction via MRI. Medical records will be abstracted to document incident diabetes and cardiovascular disease, and to reconstruct body weight trajectories. We will estimate associations between exposures during pregnancy and maternal outcomes using covariate-adjusted multivariable regression models for continuous, binary, or time-to- event data, as appropriate. Exposures will be evaluated as single pollutants and as mixtures using advanced statistical methods including Bayesian Kernel Machine Regression and Bayesian hierarchical Cox survival models. We hypothesize that maternal body mass index prior to pregnancy and diet quality during pregnancy will modify the effects of environmental chemical exposures on cardio-metabolic outcomes, such that associations will be stronger among women with obesity entering pregnancy or with poor diet quality during pregnancy. The results of this study will inform public health interventions to identify women who may be especially susceptible to the effects of environmental chemical exposures during pregnancy, and to improve the environment of pregnancy to promote the long-term health of both the offspring and the mother.

项目概要 虽然许多研究致力于探索环境化学暴露的影响 怀孕对婴幼儿健康的影响，相对较少的关注集中在这些潜在的影响上 孕产妇健康暴露。最近的证据表明怀孕可能是生命中的一个敏感时期 当然，在此期间化学物质暴露可能对心脏代谢疾病风险产生长期影响 在女性中。使用一项特征明确的现有队列研究，该研究在 2009 年招募了 1,410 名孕妇—— 2014年，我们提出以下目标：（1）量化期间环境暴露之间的关系 怀孕和短期孕产妇健康结果包括：产后体重保持、减少 母乳喂养的开始和持续时间以及糖尿病的发生； (2)量化环境之间的关系 怀孕期间的暴露和长期孕产妇健康结果：身体成分、体重轨迹 从怀孕到产后约 10 年，肝脂肪、血糖异常和糖尿病，以及 心血管疾病； (3) 评估母亲特征和行为在生育过程中的潜在作用 怀孕，特别是肥胖和饮食质量，改变环境化学物质之间的关联 暴露和结果。怀孕期间的暴露包括血清全氟烷基物质和多氟烷基物质 (PFAS)、尿邻苯二甲酸酯代谢物、苯酚和对羟基苯甲酸酯、金属、有机磷酸酯阻燃剂和 模拟了怀孕期间母亲居住地址的空气污染物。我们建议招募 700 名 最初的研究参与者在产后约 10 年返回进行随访。在本次访问中，与会者将 通过排气进行全面的代谢健康评估，包括身体成分 体积描记法 (BOD POD)、通过口服葡萄糖耐量试验检测血糖异常以及通过 MRI 检测肝脂肪分数。 医疗记录将被提取以记录糖尿病和心血管疾病的发生情况，并 重建体重轨迹。我们将估计怀孕期间的暴露与 使用协变量调整的多变量回归模型进行连续、二元或时间预测的产妇结局 事件数据（视情况而定）。暴露将被评估为单一污染物和使用先进的混合物 统计方法，包括贝叶斯核机器回归和贝叶斯分层 Cox 生存 模型。我们假设怀孕前的母亲体重指数和怀孕期间的饮食质量 将改变环境化学物质暴露对心脏代谢结果的影响，例如 怀孕期间患有肥胖症或怀孕期间饮食质量较差的女性之间的关联会更强。 怀孕。这项研究的结果将为公共卫生干预措施提供信息，以识别可能患有以下疾病的女性： 在怀孕期间特别容易受到环境化学物质暴露的影响，并改善 怀孕环境有利于后代和母亲的长期健康。