Maternal Early Adversities and Weight During Childbearing

母亲的早期不幸和生育期间的体重

• 批准号: 9761550
• 负责人: Susan M. Mason
• 金额: $ 46.52万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-10 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9761550
• 关键词: Address; Adolescence; Affect; Age; American; Automobile Driving; Behavior Control; Binge Eating; Birth Weight; Child; Child Abuse; Child Abuse and Neglect; Data; Data Set; Exposure to; Funding; Future; Health; Individual; Infant; Institute of Medicine (U.S.); Interruption; Intervention; Investigation; Knowledge; Life Cycle Stages; Link; Longevity; Mediating; Medical Records; Modeling; Nature; Obesity; Outcome; Participant; Pathway interactions; Population Heterogeneity; Pregnancy; Pregnancy Outcome; Public Health; Recording of previous events; Research; Research Personnel; Risk; Risk Factors; Surveys; Validation; Weight; Weight Gain; Weight maintenance regimen; Woman; Women' s Health; Work; abuse neglect; adult obesity; aged; career; child bearing; cohort; early life adversity; experience; high risk population; improved; innovation; insight; intergenerational; maternal weight; next generation; novel; obesity risk; population based; postpartum weight; prepregnancy; public health intervention; reproductive; response; transmission process; young adult

Abstract Early life adversities, including childhood abuse, neglect, and material hardship, affect one in three American women and are associated with an almost 40% increased risk of adult obesity. However, little is known about how these exposures influence pregnancy weight outcomes that have important public health consequences, such as excess pregnancy weight gain, postpartum weight, and infant birth weight. This knowledge gap is important because these pregnancy weight outcomes have major impacts on future obesity risk for women and their children. In preliminary work leading to this study, we found that early life adversities were associated with a 50% increased risk of excess pregnancy weight gain overall, and an 80% increased risk among women of normal pre-pregnancy weight. These findings suggest that women with early adversities should be offered interventions to improve pregnancy weight outcomes, as these could reduce subsequent obesity for both themselves and their children. However, there is currently limited research on early life adversities and pregnancy weight outcomes, which means that the mechanisms contributing to unhealthy pregnancy weight, which could inform intervention, are unknown. Our preliminary work has identified a potential set of factors that might be targeted by intervention to improve pregnancy weight outcomes: modifiable young adult risk factors such as binge eating and unhealthy weight control behaviors. These risk factors are common among women with early adversities and appear to predict excess pregnancy weight gain. We propose to conduct rigorous research building on this work, to investigate the relationships between early life adversities, young adult risk factors, and pregnancy weight outcomes. To conduct this research, we will overcome a barrier to prior studies of pregnancy weight outcomes, which is that existing datasets with pregnancy weight information have little information about women's pre-pregnancy lives. In the proposed project, we will create an innovative new cohort by linking pregnancy data from surveys and medical records with existing longitudinal information on ~520 women participating since adolescence in a 15-year study of weight-related health. This unique dataset will enable investigation of: (1) how early adversities experienced by women are associated with their pregnancy weight outcomes; (2) how early adversities are associated with young adult risk factors, and how young adult risk factors are associated with pregnancy weight outcomes; and (3) the extent to which associations between early life adversities and pregnancy weight outcomes are mediated by young adult weight-related risk factors. The proposed project answers the call of the Institute of Medicine and other experts for insight into life-course risk factors for maternal weight problems that can inform interventions across the lifespan.

摘要 三分之一的美国人在童年时受到虐待、忽视和物质困难等早年生活中的逆境的影响。 女性，与成人肥胖风险增加近40%有关。然而，人们对 这些暴露如何影响具有重要公共卫生后果的妊娠体重结果， 如妊娠期体重过度增加、产后体重和婴儿出生体重。这种知识差距是 重要的是，这些妊娠体重结果对女性未来的肥胖风险有重大影响， 子女在这项研究的前期工作中，我们发现早期生活的逆境与以下因素有关： 总体而言，妊娠期体重增加的风险增加50%， 怀孕前体重正常。这些研究结果表明，应该为早期有逆境的妇女提供 干预措施，以改善怀孕体重的结果，因为这些可以减少随后的肥胖， 他们自己和他们的孩子然而，目前对早期生活逆境的研究有限， 怀孕体重结果，这意味着导致不健康怀孕体重的机制， 哪些信息可以提供给干预，是未知的。我们的初步工作已经确定了一组潜在的因素， 可能通过干预来改善妊娠体重结果：可改变的年轻成人风险因素 比如暴饮暴食和不健康的体重控制行为。这些风险因素在女性中很常见 并似乎预示着怀孕期间体重会过度增加。我们建议进行严格的 在这项工作的基础上进行研究，调查早期生活逆境，年轻人的风险 因素和妊娠体重结果。为了进行这项研究，我们将克服先前研究的障碍， 怀孕体重结果，这是现有的数据集与怀孕体重信息很少 关于女性怀孕前生活的信息。在拟议的项目中，我们将创造一个创新的新 通过将来自调查和医疗记录的妊娠数据与以下方面的现有纵向信息联系起来， 约520名女性从青春期开始参与了一项为期15年的体重相关健康研究。这个独特的数据集 将使调查：（1）妇女经历的早期逆境如何与她们的 妊娠体重结果;（2）早期逆境与年轻成人风险因素的相关性，以及 年轻成人的危险因素与怀孕体重的结果;（3）在何种程度上， 早期生活逆境和怀孕体重结果之间的关联是由年轻人介导的 与体重有关的危险因素。该项目响应了医学研究所和其他专家的呼吁 深入了解产妇体重问题的生命过程风险因素，可以为整个国家的干预措施提供信息。 寿命