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

黑人女性妊娠期体重增加和婴儿出生体重：超越个人因素

• 批准号: 10576802
• 负责人: Suzanne M Hyer
• 金额: $ 5.77万
• 依托单位: UNIVERSITY OF CENTRAL FLORIDA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2023-10-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10576802
• 关键词: Advanced Practice Nurse; Birth; Birth Weight; Black race; Blood; Body mass index; C-reactive protein; COVID-19 pandemic; Censuses; Characteristics; Communities; Crime; Data; Development; Disease; Enrollment; Ensure; Environment; Environmental Risk Factor; Family; Fellowship; Florida; Food; Foundations; Future; Gestational Age; Health; Health Food; High birth weight infant; Hispanic; Housing; Individual; Infant; Infant Health; Inflammation; Inflammatory; Interferon Type II; Interleukin-10; Interleukin-4; Interleukin-6; Interleukin-8; Intervention; Low Birth Weight Infant; Maternal Health; Measures; Mediating; Medical Records; Mentors; Methodology; Methods; Mission; National Institute of Nursing Research; Neighborhoods; Not Hispanic or Latino; Nurse Midwives; Nurse Practitioners; Nurses; Obesity; Outcome; Parents; Pathway interactions; Perception; Plasma; Postdoctoral Fellow; Poverty; Pregnancy; Premature Birth; Questionnaires; Recommendation; Reduce health disparities; Reporting; Research; Research Personnel; Research Priority; Risk; Sampling; Scientist; Small for Gestational Age Infant; Supermarket; TNF gene; United States National Institutes of Health; Universities; Weight; Weight Gain; Woman; black women; cohort; cytokine; depressive symptoms; environmental stressor; gestational weight gain; health determinants; high risk; improved; multi-ethnic; neighborhood association; pregnant; prenatal; prepregnancy; social; social stressor; socioeconomic disadvantage; systemic inflammatory response; therapy development

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.

项目概要/摘要 妊娠期体重增加（GWG）可能是黑人实现最佳分娩结果的一个可补救因素 女性。总体而言，黑人女性更有可能肥胖（体重指数 [BMI] ≥30 kg/m2），面临不肥胖的风险 与非妊娠期相比，在怀孕期间获得最佳体重，并生下出生体重较低的婴儿 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房价较高的社区。 社会经济劣势（例如贫困）、混乱（例如空置住房）和犯罪的程度，并且 与白人相比，进入超市和选择健康食品的机会有限。邻里环境 压力源（社会经济劣势、混乱、犯罪、食物供应有限）可能会增加患病风险 GWG 不足或过多以及婴儿出生体重较低。但现有数据显示尚无定论 邻里环境压力源与 GWG 不足或过多以及婴儿的关联 出生体重。来自参加 NIH R01 研究的 620 名黑人孕妇的数据 炎症：早产前的混合方法（R01MD011575；PI Giurgescu，Co-I Misra） 将分析 COVID-19 大流行。女性在 19 至 29 点填写问卷并抽血 怀孕周数。邻里环境压力源和抑郁症状的测量方法是 孕产妇调查问卷和行政（例如人口普查）数据。全身炎症评估通过 血浆细胞因子水平（白细胞介素 [IL]-4、IL-6、IL-8、IL-10、肿瘤坏死因子 [TNF-α]、干扰素 γ [IFN-γ]）和 C 反应蛋白 [CRP]。 GWG 和出生数据将从医疗记录中获得。目标 本研究的目的是： 1) 确定邻近环境压力源与 GWG 相关的途径； 2) 确定邻近环境压力源与婴儿出生体重的相关途径。 这是第一项同时检验感知和客观测量之间关系的研究 一大群黑人孕妇中存在 GWG 的邻里环境压力源。邻里 进入健康和不健康食品商店的情况将作为 GWG 的健康决定因素进行审查。符合 国家护理研究所的优先事项，这项研究将确定护理的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 为申请人的研究奠定坚实的基础，以确保足够的 GWG 并最终 改善黑人家庭的孕产妇和婴儿健康。中央大学科研环境 佛罗里达州将支持申请人发展成为一名独立研究员和护士科学家。结果 将为未来的高级执业护士（执业护士、认证护士）干预措施提供信息 助产士）以减少黑人妇女的 GWG 和婴儿出生体重的健康差异。