Prenatal Sleep Health, Cortisol, and Gestational Weight Gain

项目摘要/摘要 过多的妊娠体重增加(GWG)会显著增加不良分娩结局的风险，并长期存在 长期的母婴健康问题。这是一个重大的公共卫生问题，因为超过一半的女性 美国的育龄人口超重或肥胖，这些比率在美国高得不成比例。 少数群体和社会经济上处于不利地位的妇女。尽管在过去的10年里努力减少过度 GWG率，产前体重增加咨询和临床干预，旨在增加体力活动和 推广健康饮食导致了不一致的结果，特别是在低收入少数族裔母亲中。因此， 有必要确定少数族裔妇女GWG过多的替代可修改预测因素以改进 目前GWG的产前保健建议。 虽然超过75%的女性报告在怀孕期间存在睡眠问题，但睡眠不佳可能是一种风险 在非怀孕人群中，睡眠在产前体重中一直受到较少的关注 获得干预。然而，当前的文学受到其横截面性质的限制，这是不允许的 检查睡眠健康维度的变化(即持续时间、连续性、警觉性、质量、 以及睡眠健康和GWG之间的关系是否因怀孕三个月而异。 此外，探索将睡眠健康和GWG联系起来的生理机制，如 下丘脑-垂体-肾上腺(HPA)轴及其副产物皮质醇在妊娠人群中仍然缺乏。 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、日间皮质醇模式和孕期GWG之间的关系。这个项目将 利用来自750名孕妇的数据，这些孕妇登记在NIH资助的母亲和发育风险研究中 环境和社会应激源(MADRES)研究(NIH P50ES026086)和65名孕妇样本 来自马德雷斯的实时个人监控子研究。这项拟议的研究将阐明产前睡眠 健康是影响少数族裔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。这笔奖学金将使我能够获得 来自跨学科教师的指导，并为我成为首席研究员的长期目标做出贡献 和研究科学家，在公共健康保护伞下整合心理生物学和行为研究 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.