Examining the Influence of Soc. Determinants of Health on Gestational WeightGain

几乎一半的美国育龄妇女体重超标或肥胖， 黑人女性和南方腹地居民妊娠期体重增加（GWG）和产后体重保持 随着时间的推移而增加，导致母亲和 后代因此，妊娠期是了解和干预导致妊娠的因素的关键时期。 过量的GWG和随后增加的风险的条件和疾病，不成比例地影响 种族/少数民族。OW/OB人群的不良结局风险最大，因此 最有可能受益并产生信息性结果;然而，缺乏关于什么的确切证据。 影响GWG的因素最多。虽然选择的个人特征解释了一些观察到的 由于种族/民族差异，即使在控制个别因素的情况下，也存在很大的差异。 进一步说明肥胖与种族的关系及其复杂性。基于多决定因素框架 在产前健康方面，拟议的研究旨在审查社会决定因素的相对贡献， 健康（例如，社会、文化和建筑环境）和人际特征（例如，年龄，种族） 200对黑人和200对白色母婴对的产妇GWG和短期健康结果， 伯明翰，AL和杰克逊，MS。此外，我们寻求使用此信息，以告知社区驱动的 促进这些社区卫生公平的方法。以下目标将由一个 来自伯明翰的亚拉巴马大学、密西西比大学 医学中心（UMMC）和杰克逊州立大学（JSU）：（1）比较种族差异的社会 健康的决定因素;（2）比较GWG（主要结局）和产科并发症（例如， GDM/胰岛素抵抗、剖腹产、高血压疾病）、出生体重、脐带血C肽 浓度、婴儿体重和产后6个月体重减轻（次要结局）;（3）检查 小学和中学健康的个人因素和社会决定因素之间的关系 （4）试点测试社区驱动的战略，以解决健康的社会决定因素。

Almost half of all US women of reproductive age are ovenweight (OW) or obese, with higher rates among black women and Deep South residents. Gestational weight gain (GWG) and retention of weight post-partum have increased over time, resulting in higher risk for numerous adverse health outcomes for mother and offspring. As such, pregnancy is a critical period for understanding and intervening on factors contributing to excess GWG and subsequent increased risk for conditions and diseases which disproportionately impact racial/ethnic minorities. The OW/OB population is at greatest risk for the adverse outcomes, and therefore most likely to benefit and yield informative results; however, there is a lack of definitive evidence about what factors most influence GWG. While select individual characteristics explain some of the observed racial/ethnic differences in outcomes, wide disparities exist even when controlling for individual factors. Further the relationship between obesity and race and complex. Grounded in a multideterminants framework of prenatal health, the proposed study seeks to examine the relative contribution of social determinants of health (e.g., social, cultural, and built environments) and interpersonal characteristics (e.g., age, race) on maternal GWG and short-term health outcomes of 200 black and 200 white mother-infant pairs in Birmingham, AL and Jackson, MS. Further, we seek to use this information to inform community-driven approaches to promote health equity in these communities. The following aims will be accomplised by a transdiciplinary team from the University of Alabama at Birmingham (UAB), the University of Mississippi Medical Center (UMMC), and Jackson State University (JSU): (1) compare racial differences in social determinants of health; (2) Compare GWG (primary outcome) and obstetric complica- tions (e.g., GDM/insulin resistance, C-section, hypertensive disorders), birth weight, umbilical cord blood c-peptide concentration, infant weight and postpartum weight loss at 6-months (secondary outcomes); (3) Examine the relationship between individual factors and social determinants of health on primary and secondary outcomes, and (4) pilot test community-driven strategies to address social determinants of health.