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Principal Investigator: Samantha L Martin
Organization: UNIVERSITY OF ALABAMA AT BIRMINGHAM
Fiscal Year: 2024
Award: $166,746
Funding agency: National Heart Lung and Blood Institute
Abstract
Children with in-utero exposure to hypertensive disorders of pregnancy (HDP; gestational hypertension, chronic
hypertension, preeclampsia, and superimposed preeclampsia) have an increased risk for hypertension and
cardiovascular disease (CVD). Our preliminary data indicate that administering first-line antihypertensives
during pregnancy improves neonatal outcomes. However, the long-term impact of in-utero exposure to
antihypertensive treatment on childhood subclinical CVD risk factors (i.e., high oxidative stress, inflammation,
and arterial stiffness) is unknown. Further, it has not been established whether environmental exposures
influence the association of in-utero exposure to HDP on childhood subclinical CVD. Assessing subclinical
CVD in childhood is particularly important because longitudinal research shows that poor
cardiovascular health in childhood is associated with a higher incidence of hypertension,
atherosclerosis, and other cardiovascular events in later life. Thus, the objectives of this study are to 1)
Investigate whether in-utero exposure to antihypertensive treatment (compared to no treatment) is associated
with improved childhood (ages 5–10 years) subclinical CVD, and 2) Examine whether neighborhood deprivation
(i.e., a composite measure of environmental exposures) influences the association between in-utero exposure
to HDP and offspring subclinical CVD. The central hypothesis is that in-utero exposure to antihypertensive
treatment is associated with improved subclinical CVD among children born to mothers with HDP. We also posit
that neighborhood deprivation significantly influences the association between in-utero exposure to HDP and
offspring subclinical CVD. Completion of the research aims in this proposal will inform the development
of an intervention to improve vascular outcomes among children born to mothers with HDP. This research plan
will be augmented by intensive mentoring from a multidisciplinary team of experts, didactic coursework, and
formal training at the University of Alabama at Birmingham and the National Heart, Lung, and Blood Institute.
The training plan was crafted to ensure that Dr. Martin achieves her specified career development goals, which
are to 1) Develop advanced skills to assess subclinical cardiovascular risk factors in children and gain a deep
understanding of the intergenerational transmission of CVD, 2) Develop expertise in the assessment of social
determinants of health and environmental exposures, 3) Develop a comprehensive knowledge of intervention
approaches and statistical analysis for clinical research in maternal-fetal-child health; and 4) Refine grant writing
skills for future grant mechanisms. Completion of the training aims in this proposal will transform clinical
care by providing new insight regarding the long-term impact of in-utero exposure to antihypertensive treatment
and will uniquely position Dr. Martin for a career that allows her to make a significant contribution to slowing the
progression of CVD for high-risk children born to mothers with HDP and other exposures.
Terms: <(TNF)-α><0-11 years old><10 year old><10 years of age><2'-deoxy-guanosine><21+ years old><Active Follow-up><Address><Adult><Adult Human><Age><Alabama><Ancillary Study><Anti-Hypertensive Agents><Anti-Hypertensive Drugs><Anti-Hypertensives><Area><Atherosclerosis><Atherosclerotic Cardiovascular Disease><Biometrics><Biometry><Biostatistics><Blood Pressure><Blood Vessels><C-reactive protein><Cachectin><Cardiovascular><Cardiovascular Body System><Cardiovascular Diseases><Cardiovascular Organ System><Cardiovascular system><Cell Communication and Signaling><Cell Signaling><Child><Child Health><Child Youth><Childhood><Children (0-21)><Chronic><Clinical><Clinical Research><Clinical Study><Collaborations><Communities><Crime><Data><Deoxyguanosine><Development><Disadvantaged><Disease Outcome><EPH Gestosis><Environment><Environmental Exposure><Event><Exposure to><F2-Isoprostanes><Fetal Growth Restriction><Fetal Growth Retardation><Fetus><Follow-Up Studies><Followup Studies><Funding><Future><Gestation><Gestational Hypertension><Goals><Grant><Guidelines><Health Care Systems><Healthcare Systems><Heart Vascular><Hypertension><Hypertension induced by pregnancy><Hypertension-Associated Pregnancy Disorder><Hypotensive Agent><Hypotensive Drugs><IUGR><Impoverished><Incidence><Inflammation><Intervention><Intervention Strategies><Intracellular Communication and Signaling><Intrauterine Growth Retardation><Investigation><Investigators><K01 Award><K01 Mechanism><K01 Program><Knowledge><Life><Macrophage-Derived TNF><Maternal Health><Measures><Mentored Research Scientist Development Award><Mentored Training Award><Mentors><Mentorship><Monocyte-Derived TNF><Mothers><NHLBI><National Heart, Lung, and Blood Institute><Neighborhoods><Organ><Outcome><Oxidative Stress><Parents><Participant><Patients><Physiologic pulse><Position><Positioning Attribute><Poverty><Pre-Eclampsia><Preeclampsia><Pregnancy><Pregnancy Associated Hypertension><Pregnancy Toxemias><Pregnant Women><Proteins, specific or class, C-reactive><Proteinuria><Proteinuria-Edema-Hypertension Gestosis><Public Health><Pulse><Randomized><Research><Research Personnel><Research Scientist Development Award><Researchers><Risk><Risk Factors><Signal Transduction><Signal Transduction Systems><Signaling><Site><Specific qualifier value><Specified><Statistical Data Analyses><Statistical Data Analysis><Statistical Data Interpretation><Stress><Subgroup><TNF><TNF A><TNF Alpha><TNF gene><TNF-α><TNFA><TNFα><Testing><Training><Transmission><Tumor Necrosis Factor><Tumor Necrosis Factor-alpha><Universities><Vascular Hypertensive Disease><Vascular Hypertensive Disorder><Woman><Writing><active followup><adulthood><adverse pregnancy outcome><age 10 years><ages><anti-hypertension><arterial stiffening><arterial stiffness><artery stiffening><artery stiffness><atheromatosis><atherosclerotic disease><atherosclerotic vascular disease><biological signal transduction><cardiovascular disease risk><cardiovascular disorder><cardiovascular disorder risk><cardiovascular health><cardiovascular risk><cardiovascular risk factor><career><career development><circulatory system><clinical care><cohort><community level disadvantage><deprivation><develop therapy><developmental><disadvantaged community><early childhood><expectant mother><expecting mother><experience><exposed in utero><fetal><fetal exposure><follow up><follow up assessment><follow-up><followed up><followup><followup assessment><high blood pressure><high risk><high risk group><high risk individual><high risk people><high risk population><hyperpiesia><hyperpiesis><hypertension treatment><hypertensive disease><hypertensive disease of pregnancy><hypertensive disorder><impaired fetal growth><improved><in utero exposure><insight><intergenerational><intervention development><interventional strategy><intra-uterine environmental exposure><intra-uterine growth restriction><intra-uterine growth retardation><intrauterine environmental exposure><intrauterine growth restriction><kids><late life><multidisciplinary><neighborhood barrier><neighborhood disadvantage><neighborhood-level barrier><neighborhood-level disadvantage><neonatal outcome><offspring><parent><pediatric><pre-eclamptic><pregnancy disorder><pregnancy hypertension><pregnancy toxemia/hypertension><pregnant mothers><prenatal exposure><prenatal growth disorder><prenatally exposed><randomisation><randomization><randomly assigned><retention rate><retention strategy><skills><social health determinants><standard care><standard treatment><statistical analysis><ten year old><ten years of age><therapy development><transmission process><treatment development><treatment trial><urinary><vascular><youngster>