Using a 24-Hour Movement Framework to Improve Pregnancy Outcomes

项目概要/摘要 母亲肥胖、妊娠期糖尿病和儿童肥胖是恶性循环的一部分。几乎一半的 美国育龄妇女超重或肥胖。超重和肥胖的女性 患GDM的可能性是正常体重女性的6倍。子宫内暴露于GDM的儿童 8-2型糖尿病风险增加1倍，肥胖风险增加2倍，使这种循环持续下去。增加体育 怀孕期间的活动和睡眠可能有助于减轻这些风险。这些行为是相互关联的：改善 一个（例如，获得更多的身体活动）可以以另一个（例如，获得足够的睡眠）为代价而发生。的 理想的日常体力活动和睡眠模式，以预防妊娠并发症和随后的儿童期 肥胖的危险因素是未知的。尽管这些行为的相互关联性，先前的研究对身体 超重和肥胖的孕妇在怀孕期间的活动、久坐行为和睡眠， 关注这些行为与围产期结局的个体关联。相互依存的 24小时运动框架内身体活动、久坐行为和睡眠之间的关系 对围产期结局的影响尚不清楚。这个K99/R 00独立之路奖的目标是 帮助我成为一名独立的研究人员，在24小时运动方面拥有专业知识， 框架，最终制定干预措施和指导方针， 这个关键时期。在此奖项的指导（K99）阶段，我将继续进行以下分析方面的培训 加速度计测量的身体活动数据，睡眠的生理学和测量，以及实用技能 在Monique博士的指导下进行研究，包括招募和保留 Hedderson（初级导师），Kelley Pettee Gabriel博士（联合导师和加速度计测量专家 24小时运动框架内的身体活动），以及Rachel Manber博士（联合导师和专家， 怀孕期间睡觉）。我在指导阶段的研究将1）评估24小时运动是否 妊娠早期的特征与妊娠晚期母体代谢生物标志物相关，以及2） 评估妊娠早期和晚期的24小时运动特征是否与分娩相关 使用现有超重和肥胖儿童研究数据， 孕妇在本奖项的独立（R 00）阶段，我将研究24- 妊娠期间的小时运动曲线与糖耐量、出生体重和新生儿肥胖 创建一组超重和肥胖的孕妇，每天进行基于设备的身体测量， 活动、久坐行为和睡眠。这些培训和研究活动将为 我成功地竞争R 01资金，以支持进一步调查24小时运动概况， 高危人群孕妇的妊娠结局。

PROJECT SUMMARY/ABSTRACT Maternal obesity, gestational diabetes, and childhood obesity are part of a vicious cycle. Almost half of all reproductive-aged women in the United States are overweight or obese. Overweight and obese women are up to 6 times more likely to develop GDM than normal weight women. Children exposed to GDM in utero have an 8-fold greater type 2 diabetes risk and a 2-fold greater obesity risk, perpetuating the cycle. Increasing physical activity and sleep during pregnancy may help mitigate these risks. These behaviors are interrelated: improving one (e.g. getting more physical activity) could occur at the expense of another (e.g. getting enough sleep). The ideal daily pattern of physical activity and sleep to prevent pregnancy complications and subsequent childhood obesity risk factors is unknown. Despite the interrelated nature of these behaviors, prior research on physical activity, sedentary behavior, and sleep during pregnancy in overweight and obese pregnanct women has focused on individual associations of these behaviors with perinatal outcomes. How the interdependent relationships between physical activity, sedentary behavior, and sleep within a 24-hour movement framework affect perinatal outcomes remains unclear. The goal of this K99/R00 Pathway to Independence Award is to facilitate my transition to becoming an independent researcher with expertise in the 24-hour movement framework during pregnancy to ultimately develop interventions and guidelines for 24-hour movement during this critical period. During the Mentored (K99) Phase of this award, I will pursue training in the analysis of accelerometer-measured physical activity data, the physiology and measurement of sleep, and practical skills in research study conduct, including recruitment and retention, under the mentorship of Dr. Monique Hedderson (Primary Mentor), Dr. Kelley Pettee Gabriel (Co-Mentor and expert in accelerometer-measured physical activity within a 24-hour movement framework), and Dr. Rachel Manber (Co-Mentor and expert in sleep during pregnancy). My research during the Mentored Phase will 1) assess whether 24-hour movement profiles during early pregnancy are associated with late pregnancy maternal metabolic biomarkers, and 2) assess whether 24-hour movement profiles during early and late pregnancy are associated with delivering infants with childhood obesity risk factors using data from an existing study among overweight and obese pregnant women. In the Independent (R00) Phase of this award, I will examine longitudinal relationships of 24- hour movement profiles during pregnancy with glucose tolerance, birthweight, and neonatal adiposity by creating a cohort of overweight and obese pregnant women with daily, device-based measurement of physical activity, sedentary behavior, and sleep across pregnancy. These training and research activities will prepare me to successfully compete for R01 funding to support further investigation of 24-hour movement profiles and pregnancy outcomes in high-risk populations of pregnant women.