Prenatal Sleep Health, Cortisol, and Gestational Weight Gain

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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.