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

项目摘要/摘要（行政补充）

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.