Intergenerational Obesity: Do Early Adversity and Pregnancy Explain Disparities?

描述（由申请人提供）：虽然遗传易感性肯定会导致肥胖，但目前肥胖的种族/民族差异在很大程度上仍然无法解释。妇女在生育期间患肥胖症的风险特别大；然而，黑人、西班牙裔和非西班牙裔白人女性在怀孕前、怀孕期间和怀孕后体重增加的关系可能有所不同。母亲在受孕时肥胖和/或怀孕期间体重过度增加也可能显著影响后代代谢过程的发育和编程——这种影响也可能因种族/民族而异。因此，对于母亲和孩子来说，生育代表了一个重要的发展窗口，在这个窗口中，我们可以探索肥胖的种族/民族差异的起源。这个项目的目的是调查种族/民族差异在几个因素之间的影响和相互作用，这些因素可能会增加中年母亲的体重指数和后代的肥胖：母亲早期的社会环境（如社会经济地位和家庭结构）、与妊娠相关的体重（如妊娠期体重过度增加和产后体重潴留）以及不良的母亲童年经历（如家庭中的身体虐待、药物滥用或精神疾病）。美国1979年全国青年纵向调查（NLSY）及其对NLSY女性所生子女的配套研究为开展队列研究提供了有价值的数据集。这些备受尊敬的、具有全国代表性的研究对大约4000名美国妇女和她们的孩子进行了研究，提供了一个独特的机会来评估与胎次有关的体重、社会经济和心理因素以及一代母亲和她们的孩子的体重指数。该提案的一个创新之处在于收集了2012年NLSY浪潮中母亲不良童年经历历史的新数据。我们将利用以前曾在其他研究项目中合作过的机构合作者的专业知识，他们的专业知识涵盖围产期流行病学、营养和肥胖、神经生物学、健康差异、心理学、社会流行病学和生物统计学等领域。我们假设：1)在调整孕前BMI和当前社会环境后，妊娠期体重过度增加和产后体重保持会介导早期社会劣势与中年BMI之间的关联，且黑人女性的这种中介作用更大；2)调整当前社会环境后，母亲的早期社会环境和孕前、孕期和产后的高体重是后代肥胖种族差异增加的途径；3)母亲的童年不良经历史将解释早期社会环境和怀孕体重增加与母亲和儿童BMI之间的很大一部分关联，并根据当前的社会环境进行调整。

DESCRIPTION (provided by applicant): While genetic predisposition certainly contributes to obesity, the existing racial/ethnic disparities in obesity remain largely unexplained. Women are at special risk for developing obesity during childbearing; however, the relationship between weight gain before, during and after pregnancy may differ between black, Hispanic, and non-Hispanic white women. Maternal obesity at conception and/or excessive weight gain during pregnancy may also significantly influence the development and programming of metabolic processes in offspring - impacts which may also vary by race/ethnicity. Therefore childbearing represents an important developmental window within which to explore the origins of racial/ethnic disparities in obesity - for both mothers and their children. The purpose of this project is to investigate racial/ethnic differences in the impact and interactions between several factors that may increase maternal BMI at mid-life as well as obesity in offspring: early maternal social environment (e.g., socioeconomic status and family structure), pregnancy- related weight (e.g., excessive gestational weight gain and postpartum weight retention), and adverse maternal childhood experiences (e.g., physical abuse, substance abuse or mental illness in the home). The U.S. 1979 National Longitudinal Survey of Youth (NLSY) and its companion study of children born to NLSY females provide a valuable data set to conduct a cohort study. These highly respected, nationally representative studies of approximately 4000 U.S. women and their children provide a unique opportunity to assess parity- related weight, socioeconomic and psychological factors, and BMI across one generation of mothers and their children. An innovative feature of this proposal is the collection of new data on history of maternal adverse childhood experiences in the 2012 wave of the NLSY. We will capitalize on expertise of collaborators from institutions that have worked together previously on other research projects and whose expertise spans the fields of perinatal epidemiology, nutrition and obesity, neurobiology, health disparities, psychology, social epidemiology and biostatistics. We hypothesize that: 1) after adjusting for pre-pregnancy BMI and current social environment, excessive gestational weight gain and postpartum weight retention will mediate the association between early social disadvantage and mid-life BMI and that this mediation will be larger for black women; 2) after adjusting for current social environment, a mother's early social environment and high weight before, during and after pregnancy represent pathways through which racial disparities in offspring obesity are increased; and 3) maternal history of childhood adverse experiences will explain a substantial portion of the association between early social environment and pregnancy weight gain with maternal and child BMI, adjusting for current social environment. PUBLIC HEALTH RELEVANCE: The combination of early childhood adversity and excessive gestational weight gain during pregnancy together suggest a potential unexplored pathway which may contribute to racial/ethnic disparities in obesity in women and their children. Understanding how maternal early life experiences and maternal weight before, during and after pregnancy, contribute, individually and jointly, to the development of maternal and child obesity by race/ethnicity stands to open the door for the development of novel approaches to obesity prevention.