Gestational weight gain and infant birthweight among Black women: Beyond individual-level factors

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Project Summary/Abstract Gestational weight gain (GWG) may be a remediable factor in achieving optimal birth outcomes for Black women. Overall, Black women are more likely to be obese (body mass index [BMI] ≥30 kg/m2), at risk for not gaining optimal weight during pregnancy, and delivering an infant of lower birthweight compared with non- Hispanic white and Hispanic women. Black women are also more likely to reside in neighborhoods with higher levels of socioeconomic disadvantage (e.g., poverty), disorder (e.g., vacant housing) and crime, and have limited access to supermarkets and healthy food options compared with whites. Neighborhood environmental stressors (socioeconomic disadvantage, disorder, crime, limited food accessibility) may increase the risk for either inadequate or excessive GWG and lower infant birthweight. However, existing data show inconclusive associations of neighborhood environmental stressors with inadequate or excessive GWG and infant birthweight. Data from 620 pregnant Black women enrolled in the NIH R01 study Social stressors and inflammation: A mixed methods approach to preterm birth (R01MD011575; PI Giurgescu, Co-I Misra) prior to the COVID-19 pandemic will be analyzed. Women completed questionnaires and had blood drawn at 19-29 weeks gestation. Neighborhood environmental stressors and depressive symptoms were measured by maternal questionnaires and administrative (e.g., census) data. Systemic inflammation was assessed by plasma levels of cytokines (interleukin [IL]-4, IL-6, IL-8, IL-10, tumor necrosis factor [TNF-α], interferon gamma [IFN-γ]) and C-Reactive Protein [CRP]. GWG and birth data will be obtained from medical records. The aims of this study are to: 1) Determine the pathways by which neighborhood environmental stressors relate to GWG; and 2) Determine the pathways by which neighborhood environmental stressors relate to infant birthweight. This is the first study to simultaneously examine the relationship of perceived and objectively measured neighborhood environmental stressors with GWG in a large cohort of pregnant Black women. Neighborhood access to healthy and unhealthy food stores will be examined as a health determinant to GWG. In line with the National Institute of Nursing Research’s priorities, this study will identify social and physical determinants of GWG and infant birthweight among Black women. The objectives and specific aims are highly relevant to the mission to promote and improve health individuals, families, and communities. The postdoctoral fellowship will provide a strong foundation on which to build the applicant’s research to ensure adequate GWG and ultimately improve maternal and infant health among Black families. The research environment at University of Central Florida will support the applicant’s development into an independent researcher and nurse scientist. Results will inform future interventions with advanced practice nurses (nurse practitioners, certified nurse midwives) to reduce health disparities in GWG and infant birthweight among Black women.