Brain-Gut Axis and Its Influence on Gestational Weight Gain

 描述(申请人提供)：近三分之二的美国育龄妇女超重或肥胖，近一半，一旦怀孕，妊娠体重增加(GWG)。GWG过多是妇女及其婴儿产科结局差和终身健康风险的重要预测指标。肥胖通常会随着每次怀孕和年龄的增加而恶化，它会增加产科和胎儿的并发症。GWG不足也对母婴构成风险。在几乎所有的BMI类别中，非裔美国人(AA)女性先前存在的肥胖率以及GWG过高和不足的比例都高于其他种族的女性。目前，与GWG过多和不足相关的生物行为因素知之甚少，但为了改善结果，必须确定这些因素，特别是对于AA女性。在拟议的初步研究中，我们将测试这一假设，即导致GWG模式的种族内变异性的潜在机制是怀孕期间肠道微生物群的结构和动态，进一步，大脑-肠轴受到被确定为GWG重要贡献者的生物行为因素的影响。越来越多的证据表明，肠道微生物群在很大程度上影响着胃肠道和大脑之间的双向信号传递。人们对ut微生物群和脑-肠轴的种族内差异知之甚少。对于BMI类别中的肠道微生物群，怀孕期间的微生物群变化，以及与GWG相关的母亲行为特征，人们知之甚少。在父母研究中，怀孕的AA妇女在第一和第二个三个月期间从18到35岁的妇女中招募。对于拟议的子研究，将为80名妇女的子集增加一次额外的晚期妊娠产前接触。这次访问将在怀孕35-41周之间进行，包括第三次直肠拭子和完成关于压力、情绪和饮食的问卷调查。子研究中使用的几乎所有数据将来自第一和第三个三个月的数据收集。在分析后，将使用两样本t检验或ANOVA来比较微生物的对数转化。为了比较同一妇女从怀孕第一到第三个三个月的时间点内微生物的百分比，将对对数转换的百分比进行配对t检验。对于更详细的时间点趋势分析，将进行混合效应方差分析。在对生物和/或心理社会因素进行调整后，将使用偏相关分析来检验结果与时间间隔和/或总GWG之间的成对线性关联。随着父母研究的进行，一个强大的研究团队正在积极调查微生物组在再生障碍性贫血妇女产科结局中的作用，特别是早产。爱德华兹女士，这项拟议研究的PI，正在获得重要的经验 并准备开始收集数据和分析结果。由于肥胖和不适当的GWG是已知的导致出生结果和慢性病种族差异的因素，拟议的研究将成为改善AA家庭健康差异的一步。

 DESCRIPTION (provided by applicant): Nearly two-thirds of US women of childbearing age are overweight or obese and nearly half, once pregnant, have excessive gestational weight gain (GWG). Excessive GWG is a significant predictor of poor obstetric outcomes and lifelong health risks for a woman and her infant. Obesity, which oftentimes worsens with each pregnancy and advancing age, increases obstetric and fetal complications. Inadequate GWG also poses risks to the mother and infant. African American (AA) women's rates of preexisting obesity and both excessive and inadequate GWG is higher than rates for women of other races, across nearly all BMI categories. Currently, the biobehavioral factors associated with excessive and inadequate GWG are poorly understood, yet in order to improve outcomes, are essential to identify, particularly for AA women. In the proposed pilot study, we will test the hypothesis that an underlying mechanism that contributes to within-race variability in GWG patterns is the structure and dynamics of the gut microbiome during pregnancy and, further, that the brain-gut axis is influenced by biobehavioral factors identified as important contributors to GWG. Increasing evidence supports that the gut microbiome greatly influences the bidirectional signaling between the gastrointestinal tract and the brain. Little is known about the intra-racial variations in the ut microbiome and the brain-gut axis. Even less is known about the gut microbiome across BMI categories, microbiome changes in pregnancy, and maternal behavior profiles linked with GWG. In the parent study, pregnant AA women are recruited among 18 to 35 year-old women during the 1st and 2nd trimesters. For the proposed sub-study an additional 3rd trimester prenatal encounter will be added for a subset of 80 women. This visit will occur between 35-41 weeks' gestation and will involve a 3rd rectal swab and completion of questionnaires on stress, mood, and diet. Nearly all data used in the sub-study will be from the 1st and 3rd trimester data collections. Upon analysis, a two-sample t-test or ANOVA will be used to compare the logarithm transformations of microbes. To compare the percentage of microbes within the same women from 1st to 3rd trimester time points, a paired t-test will be performed on the logarithm transformed percentages. For a more detailed trend analysis over the time points, a mixed effects ANOVA will be performed. Partial correlation analyses will be used to test for pairwise linear associations between the outcomes and interval and/or total GWG after adjusting for the biological and/or psychosocial factors. With the parent study underway, a strong research team is actively investigating the role of the microbiome in AA women's obstetric outcomes, particularly preterm birth. Ms. Edwards, the PI of this proposed study, is gaining vital experience and is poised to begin collecting data and analyzing results. As obesity and improper GWG are known contributors to racial disparities in birth outcomes and chronic conditions, the proposed study will serve as a step toward ameliorating health disparities in AA families.