Postpartum Weight Retention and Cardiometabolic Disparities: The Effects of Contexual, Psychosocial, and Behavioral Factors

项目概要/摘要（行政补充） 在孕产妇发病率和死亡率方面长期存在种族/族裔不平等， 妇女发生孕产妇健康并发症的可能性是妇女的2-3倍， 相关的高血压、严重的心脏代谢风险以及孕产妇死亡。结构性种族主义 新冠肺炎大流行加剧了健康方面的不平等，包括怀孕期间的不平等 和产后时期。越来越多的研究表明， 结构性种族主义以及日常的种族主义和其他形式的压迫如何 人口，特别是黑人妇女和分娩的人，健康状况不佳， 无论收入和教育。这份行政补充文件试图解决两个问题 关键问题，COVID大流行对孕产妇健康和福祉的影响。和方式 结构性种族主义在其各种表现和层面上影响着心脏代谢， 孕妇和产后人群的健康和体重轨迹。我们将利用 正在进行的产后母亲移动的研究（PMOMS）， 妊娠期和产后1年，并辅助GDM 2试验（PI：Davis）。 PMOMS采用了一种新的方法，使用生态瞬时评估（EMA）， 真实的实时采集数据;使用智能手机技术和智能秤采集 心理社会行为和位置数据。 该补编将实现以下目标： 目的1：确定COVID-19对心理社会压力、情绪和经历的影响， 怀孕期间和产后期间的种族主义（和其他形式的歧视）。 目标2：调查结构性种族主义（从多个方面衡量）与 和域）以及怀孕和分娩（例如，产后体重，心脏代谢健康，小- 胎龄出生）。 目的3：探索怀孕和产后的人的经验，了解关键 PMOMS的研究成果，特别是与COVID-19和SRD相关的研究成果， 以社区为基础的宣传计划，以供今后采取行动和干预措施。 整个PMOMS研究和行政补充的结果有可能 通过确定最佳时间点，推进卫生、临床和公共卫生实践， 干预的频率。该补充将是至关重要的，在进一步了解我们的 COVID-19和结构性种族主义对孕产妇健康的影响， 解决孕产妇健康危机的办法，特别是对黑人的深刻影响 女人和分娩的人。

Project Summary/Abstract (Administrative Supplement) There are long-standing racial/ethnic inequities in maternal morbidity and mortality where Black women are 2-3 times as likely to experience maternal health complications such pregnancy- related hypertension, severe cardiometabolic risk as well as maternal death. Structural racism and the COVID-19 pandemic has exacerbated inequities in health, including during pregnancy and the postpartum period. There is a growing body of research demonstrating the effects of structural racism as well as how daily experiences of racism and other forms of oppression send populations, Black women and birthing people in particular, on a trajectory of adverse health, regardless of income and education. This administrative supplement attempts to address two key issues, the effects of the COVID pandemic on maternal health and well-being. and the ways in which structural racism in its various manifestations and dimensions effects cardiometabolic health and weight trajectories among pregnant and postpartum populations. We will leverage the ongoing Postpartum Mothers Mobile (PMOMS) Study which is following women during pregnancy and through one year postpartum and is ancillary to the GDM2 Trial (PI: Davis). PMOMS takes a novel approach using ecological momentary assessment (EMA), which is collecting data in real time; and using smart phone technology and smart scales to collect psychosocial, behavioral and location data. The supplement will address the following aims: Aim 1: Determine the influence of COVID-19 on psychosocial stress, mood and experiences of racism (and other forms of discrimination) during pregnancy and the postpartum period. Aim 2: Investigate the association between structural racism (measured by multiple dimensions and domains) and pregnancy and birth (e.g., postpartum weight, cardiometabolic health, small- for-gestational-age birth). Aim 3: Explore pregnant and postpartum people’s experiences with understanding the key research findings from PMOMS and specifically related to COVID-19 and SRD to develop a community-based dissemination plan for future action and interventions. The results of the overall PMOMS study and the administrative supplement has the potential to advance health and clinical and public health practice by determining optimal points of time and frequency for intervention. The supplement will be critical in furthering our understanding of the effects of COVID-19 and structural racism on maternal health and for long-term, sustainable solutions to addressing the maternal health crisis and particularly the profound impact on Black women and birthing people.