Prenatal Sleep Health, Cortisol, and Gestational Weight Gain

项目概要/摘要 妊娠期体重增加过多（GWG）会显著增加不良出生结局的风险， 长期的妇幼保健问题。这是一个重大的公共卫生问题，因为超过一半的妇女 在美国，育龄妇女超重或肥胖，这些比率在美国高得不成比例。 少数民族和社会经济弱势妇女。尽管过去10年来努力减少过度的 GWG率，产前体重增加咨询和临床干预，旨在增加体力活动， 提倡健康饮食的做法导致了不一致的结果，特别是在低收入的少数民族母亲中。因此，在本发明中， 有必要确定少数民族妇女过度GWG的替代可修改的预测因素，以改善 GWG目前的产前护理建议。 虽然超过75%的妇女报告说，在怀孕期间的睡眠问题，睡眠不好是一个假定的风险， 在非怀孕人群中，睡眠是肥胖的一个因素，但在产前体重方面，睡眠一直受到较少的关注 获得干预。然而，目前的文献受到其横截面性质的限制，这不允许 检查睡眠健康维度（即持续时间、连续性、警觉性、质量， 和时间），或者睡眠健康和GWG之间的关系是否因三个月而异。 此外，探索将睡眠健康与GWG联系起来的生理机制，例如 下丘脑-垂体-肾上腺（HPA）轴及其副产物皮质醇，仍然缺乏怀孕人群。 这项研究的总体目标是检查人口水平（人与人之间）和日水平（人与人之间） 睡眠健康，昼夜皮质醇模式和整个怀孕期间GWG之间的关联。该项目将 利用750名参加NIH资助的孕产妇和发育风险研究的孕妇的数据， 环境和社会压力源（MADRES）研究（NIH P50 ES 026086）和65名孕妇样本 来自MADRES的实时个人监测子研究。这项拟议中的研究将阐明产前睡眠 健康是影响少数群体母亲体重增加趋势的重要因素。因此，研究结果将有助于确定 睡眠健康作为未来过度GWG干预的目标行为。这个奖学金将让我得到 来自跨学科教师的指导，并有助于我成为首席研究员的长期目标 他是一位将心理生物学和行为学研究整合在公共卫生保护伞下的研究科学家 改善孕产妇、儿童和家庭健康状况。

PROJECT SUMMARY/ABSTRACT Excessive gestational weight gain (GWG) significantly increases the risk of adverse birth outcomes and long- term maternal and child health issues. This is a significant public health concern, because over half of women of child-bearing age in the United States are overweight or obese, and these rates are disproportionately higher in minority and socioeconomically disadvantaged women. Despite efforts in the last 10 years to curtail excessive GWG rates, prenatal weight gain counseling and clinical interventions aimed at increasing physical activity and promoting healthy eating have led to inconsistent results, especially among low-income minority mothers. Thus, there is a need to identify alternative modifiable predictors of excessive GWG in minority women to improve the current prenatal care recommendations for GWG. Although more than 75% of women report sleep problems during pregnancy, and poor sleep is a putative risk factor for obesity in non-pregnant populations, sleep has consistently received less attention in prenatal weight gain interventions. However, current literature is limited by their cross-sectional nature, which does not permit examination of the effects of change in sleep health dimensions (i.e. duration, continuity, alertness, quality, and timing) during pregnancy or whether the relationship between sleep health and GWG differ by trimester. Furthermore, exploration of physiological mechanisms that link sleep health and GWG, such as the hypothalamic-pituitary-adrenal (HPA) axis and its by-product cortisol, is still lacking in pregnant populations. The overall goal of this study is to examine both population-level (between-person) and day-level (within-person) associations among sleep health, diurnal cortisol patterns, and GWG throughout pregnancy. This project will leverage data from 750 pregnant women enrolled in the NIH-funded Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) Study (NIH P50ES026086) and a sample of 65 pregnant women from the real-time personal monitoring sub-study in MADRES. The proposed study will elucidate prenatal sleep health as an important factor that informs weight gain trends in minority mothers. Thus, findings will help identify sleep health as a target behavior for future excessive GWG interventions. This fellowship will allow me to receive mentorship from interdisciplinary faculty and contribute to my long-term goal of becoming a Principal Investigator and research scientist who integrates psychobiological and behavioral research under a public health umbrella to improve maternal, child, and family health outcomes.