Intergenerational Obesity: Do Early Adversity and Pregnancy Explain Disparities?

描述（由申请人提供）：虽然遗传易感性肯定会导致肥胖，但肥胖症中现有的种族/民族差异在很大程度上仍然无法解释。女性在生育期间有发生肥胖的特殊风险;然而，黑人、西班牙裔和非西班牙裔白色女性在怀孕前、怀孕期间和怀孕后体重增加之间的关系可能不同。母亲怀孕时肥胖和/或怀孕期间体重过度增加也可能显著影响后代代谢过程的发育和编程-影响也可能因种族/民族而异。因此，生育是一个重要的发展窗口，在此范围内探索肥胖的种族/民族差异的起源-母亲和他们的孩子。本项目的目的是调查可能增加中年母亲BMI以及后代肥胖的几个因素之间的影响和相互作用的种族/民族差异：早期母亲社会环境（例如，社会经济地位和家庭结构），怀孕相关的体重（例如，过度的妊娠期体重增加和产后体重保持），和不利的母亲童年经历（例如，家庭中的身体虐待、药物滥用或精神疾病）。美国1979年全国青年纵向调查（NLSY）及其对NLSY女性所生子女的同伴研究为进行队列研究提供了有价值的数据集。这些备受推崇的、具有全国代表性的研究涉及约4000名美国妇女及其子女，为评估一代母亲及其子女的与产次相关的体重、社会经济和心理因素以及BMI提供了独特的机会。该提案的一个创新特点是在2012年NLSY浪潮中收集关于母亲不良童年经历历史的新数据。我们将利用合作者的专业知识，他们来自以前曾在其他研究项目上合作过的机构，他们的专业知识涵盖围产期流行病学，营养和肥胖，神经生物学，健康差异，心理学，社会流行病学和生物统计学等领域。我们假设：1）在调整孕前BMI和当前社会环境后，过度妊娠体重增加和产后体重保留将介导早期社会劣势与中年BMI之间的关联，并且这种介导作用对黑人女性更大; 2）在适应了当前的社会环境后，母亲早期的社会环境和以前的高体重，怀孕期间和怀孕后代表了后代肥胖的种族差异增加的途径;和3）母亲的童年不良经历史将解释早期社会环境和妊娠体重增加与母亲和儿童BMI之间的关联的很大一部分，适应当前社会环境。 公共卫生相关性：儿童早期逆境和妊娠期体重过度增加的组合表明，一个潜在的未探索的途径，可能会导致种族/民族的差异，在肥胖的妇女和他们的孩子。了解母亲的早期生活经验和母亲的体重之前，期间和之后怀孕，有助于单独和共同的发展，孕产妇和儿童肥胖的种族/民族的立场打开大门，为开发新的方法来预防肥胖。

DESCRIPTION (provided by applicant): While genetic predisposition certainly contributes to obesity, the existing racial/ethnic disparities in obesity remain largely unexplained. Women are at special risk for developing obesity during childbearing; however, the relationship between weight gain before, during and after pregnancy may differ between black, Hispanic, and non-Hispanic white women. Maternal obesity at conception and/or excessive weight gain during pregnancy may also significantly influence the development and programming of metabolic processes in offspring - impacts which may also vary by race/ethnicity. Therefore childbearing represents an important developmental window within which to explore the origins of racial/ethnic disparities in obesity - for both mothers and their children. The purpose of this project is to investigate racial/ethnic differences in the impact and interactions between several factors that may increase maternal BMI at mid-life as well as obesity in offspring: early maternal social environment (e.g., socioeconomic status and family structure), pregnancy- related weight (e.g., excessive gestational weight gain and postpartum weight retention), and adverse maternal childhood experiences (e.g., physical abuse, substance abuse or mental illness in the home). The U.S. 1979 National Longitudinal Survey of Youth (NLSY) and its companion study of children born to NLSY females provide a valuable data set to conduct a cohort study. These highly respected, nationally representative studies of approximately 4000 U.S. women and their children provide a unique opportunity to assess parity- related weight, socioeconomic and psychological factors, and BMI across one generation of mothers and their children. An innovative feature of this proposal is the collection of new data on history of maternal adverse childhood experiences in the 2012 wave of the NLSY. We will capitalize on expertise of collaborators from institutions that have worked together previously on other research projects and whose expertise spans the fields of perinatal epidemiology, nutrition and obesity, neurobiology, health disparities, psychology, social epidemiology and biostatistics. We hypothesize that: 1) after adjusting for pre-pregnancy BMI and current social environment, excessive gestational weight gain and postpartum weight retention will mediate the association between early social disadvantage and mid-life BMI and that this mediation will be larger for black women; 2) after adjusting for current social environment, a mother's early social environment and high weight before, during and after pregnancy represent pathways through which racial disparities in offspring obesity are increased; and 3) maternal history of childhood adverse experiences will explain a substantial portion of the association between early social environment and pregnancy weight gain with maternal and child BMI, adjusting for current social environment. PUBLIC HEALTH RELEVANCE: The combination of early childhood adversity and excessive gestational weight gain during pregnancy together suggest a potential unexplored pathway which may contribute to racial/ethnic disparities in obesity in women and their children. Understanding how maternal early life experiences and maternal weight before, during and after pregnancy, contribute, individually and jointly, to the development of maternal and child obesity by race/ethnicity stands to open the door for the development of novel approaches to obesity prevention.