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

项目摘要/摘要 妊娠期体重增加(GWG)可能是黑人获得最佳出生结局的一个可补救因素 女人。总体而言，黑人女性更有可能肥胖(体重指数≥为30公斤/平方米)，面临不肥胖的风险 在怀孕期间增加最佳体重，并生下比没有出生体重更低的婴儿 西班牙裔白人和西班牙裔女性。黑人女性也更有可能居住在高收入社区 社会经济劣势(例如贫穷)、混乱(例如空置房屋)和犯罪的程度，并有 与白人相比，进入超市的机会和健康食品的选择有限。邻里环境 应激源(社会经济劣势、混乱、犯罪、食物可获得性有限)可能会增加患癌症的风险 GWG不足或过高，以及婴儿出生体重较低。然而，现有的数据显示，没有定论 社区环境应激源与GWG不足或过多与婴儿的关系 出生体重。参加NIH R01研究的620名怀孕黑人女性的数据来自社会压力源和 炎症：早产的混合方法(R01MD011575；Pi Giurescu，Co-I Misra) 将对新冠肺炎大流行进行分析。女性完成问卷调查，并在19-29岁抽血 怀孕几周。社区环境应激源和抑郁症状的测量 产妇问卷和行政(例如，人口普查)数据。通过以下方法评估全身炎症 血浆细胞因子(IL-4、IL-6、IL-8、IL-10、肿瘤坏死因子-α、干扰素-γ)水平 [干扰素-γ])和C反应蛋白[C反应蛋白]。GWG和出生数据将从医疗记录中获得。目标 本研究的主要目的是：1)确定邻里环境应激源与GWG相关的途径； 2)确定邻里环境应激源与婴儿出生体重的关系。 这是第一次同时检查感知和客观测量的关系的研究 GWG在一大群怀孕的黑人妇女中发现了社区环境应激源。邻里 健康和不健康食品店的使用情况将被视为全球工作组的健康决定因素。符合 国家护理研究所的优先事项，这项研究将确定社会和身体决定因素 黑人女性的GWG和婴儿出生体重。目标和具体目标与 促进和改善个人、家庭和社区健康的使命。博士后奖学金将 提供坚实的基础，以建立申请人的研究，以确保充分的全球工作组，并最终 改善黑人家庭的母婴健康。中央大学的研究环境 佛罗里达州将支持申请者发展成为独立研究人员和护士科学家。结果 将通知高级执业护士(执业护士、认证护士)未来的干预措施 助产士)，以减少黑人妇女在GWG和婴儿出生体重方面的健康差距。

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.